The therapeutic effect of radiofrequency ablation(RFA) combining with/without chemotherapy in treating inoperable liver metastases of colorectal cancers

Abstract

13581 Background: Patients (pts) with colorectal cancer often develop metastases to the liver without extra hepatic spread. Surgery is the mainstay of treatment in these pts, but only 20% of pts are suitable for a surgical approach and some pts are reluctant to receive surgery. This study is to compare the therapeutic effect of RFA combining with chemotherapy and RFA alone in treating inoperable liver metastases of colorectal cancers. Methods: From May 2001 to July 2005, 26 patients have inoperable liver metastases derived from colorectal cancer whose primary tumors were resected. Among them, 14 pts received chemotherapy from 3 months before RFA to 3 months after RFA (13 pts received systemic chemotherapy with FOLFOX4, 1 pt received FOLFIRI), 12 pts didn’t receive any chemotherapy. The metastatic lesions in liver were evaluated by CT scan every 3 months. Results: Pts’ characteristics: m/f 18/8; median age 57 yrs (range, 31–68); primary tumor: colon 15, rectum 11; karnofsky’s score≥60. Median no. of LM: 2.2 (range, 1–7), mean size of LM: 24mm (range, 12–97 mm). The last time of follow-up visit is Nov 2005, 11 pts has been dead because of tumor progression, 14 pts is still living, and 1 patient is lost to follow-up. The main complication of RFA is fever, local pain and elevation of hepatic enzyme. Reactive pleural effusion occurred in 1 patient which disappeared after thoracentesis. No RFA related bleeding,pneumathorax,perforation of digestive tract,infection and needle track implantation occurred. The median survival,1-year survival rates and 2-year survival rates in all pts were 33 months, 83.8% and 64.1% respectively. The median time to local progression in all pts is 346 days. In the pts treated with RFA alone, the median survival,1-year survival rates and 2-year survival rates were 18 months, 71.3% and 38.2% respectively; in the pts treated with RFA and chemotherapy, they were 36.5 months, 92.9% and 85.1% respectively (P=0.0210). In the pts treated with RFA alone, the median time to local progression is 346 days; in the pts treated with RFA and chemotherapy, it is 317 days (P>0.05). Conclusions: RFA Combining with chemotherapy is safe and may be more effective than RFA alone in treating inoperable liver metastases of colorectal cancer. No significant financial relationships to disclose.