Percutaneous radiofrequency ablation of hepatic metastases. Preliminary experience

Aim - To evaluate the efficiency of percutaneous radiofrequency ablation in the treatment of liver metastases. Methods - Eighteen patients with 31 liver metastases, mainly from colorecta l cancer 10 - 35 mm in diameter (m = 23), undeawent 26 courses of percutane ous radiofrequency ablation. Fifteen patients had previously undergone hepa tectomy, and 3 patients had contra-indications to surgery. Imaging guidance was ultrasound in 21 patients, CT in 4 (tumors not seen with ultrasound), and both in 1. A generator working at 450 KHz with a maximum output power o f 150 W was used to heat each lesion for 18 - 20 min. Treatment was monitor ed,vith real time, ultrasound. Results - Among the 12 patients followed more than 3 months, only one of th e 24 treated lesions recurred after a mean follow up of 259 +/- 109 days. L iver disease was controlled in 8 of the 12 patients after 90 - 509 days (m = 306). Among these 8 patients, 3 were tumor free after 559, 378 and 90 day s, respectively; 2 died tumor free of non-tumoral disease (pulmonary emboli sm, digestive bleeding); 3 developed lung metastases treated with chemother apy (n = 2) or surgery (n = 1). Three of the 12 patients had widespread hep atic tumor occurrence, and one patient died of these metastases. Six patien ts experienced mild skin burns, but no major complication was observed. Conclusion - Radiofrequency ablation of hepatic metastases appears safe and promising in this preliminary experience. Further investigation is needed.