Radiofrequency ablation of 100 hepatic metastases with a mean follow-up ofmore than 1 year

OBJECTIVE. The objective of our study was to evaluate the efficacy and safe ty of radiofrequency ablation of hepatic metastases performed either percut aneously for treatment of hepatic metastases in patients deemed ineligible for surgery or intraoperatively during partial hepatectomy to destroy unres ectable metastases. SUBJECTS AND METHODS. Sixty-eight patients with 121 hepatic metastases (<5 metastases per patient) that were mainly colorectal in origin underwent 76 sessions of radiofrequency ablation with cooled-needle electrodes under son ographic guidance. Twenty-one patients with 33 metastases of 5-20 mm in dia meter (mean +/- SD,13 +/- 7 mm) underwent intraoperative radiofrequency abl ation. Forty-seven patients with 88 metastases of 10 to 42 mm in diameter ( mean +/- SD, 26 +/- 9 mm) were treated with percutaneous radiofrequency abl ation. Procedure efficacy was evaluated with dynamic enhanced CT and MR ima ging performed 2, 4, and 6 months after treatment and then every 3 months. RESULTS. Radiofrequency ablation allowed eradication of 91% of the 100 trea ted metastases that were followed up for 4-23 months (mean, 13.7 months). T umor control was equivalent for percutaneous radiofrequency ablation (90%) and for intraoperative radiofrequency ablation (94%). Failure to achieve tu mor control occurred mostly with the largest tumor nodules. One bilioperito neum and two abscesses were the major complications encountered after treat ment of 121 metastases with a follow-up of more than 2 months. CONCLUSION. Radiofrequency ablation appears to be a promising therapeutic m odality capable of extending the possibilities of partial hepatectomy and o f efficiently treating small metastases percutaneously.