gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Radiofrequency ablation for the treatment of liver tumors - Choice of the best approach

Meeting Abstract

  • corresponding author presenting/speaker Guido Schumacher - Charité Campus Virchow Klinikum, Berlin, Deutschland
  • Alexandra Kunath - Charité Campus Virchow Klinikum, Berlin
  • Robert Eisele - Charité Campus Virchow Klinikum, Berlin
  • Antonino Spinelli - Istituto Clinico Humanitas, Milan, Italy
  • Peter Neuhaus - Charité Campus Virchow Klinikum, Berlin

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP167

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk277.shtml

Veröffentlicht: 20. März 2006

© 2006 Schumacher et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Radiofrequency ablation (RFA) has become an established method for the treatment of inoperable liver tumors. Even with aggressive surgical treatment, a large percentage of small tumors cannot be resected. Liver transplantation is an option almost only for hepatocellular carcinoma (HCC) in cirrhosis. We here report on our experience of RFA using a percutaneous, laparoscopic, or open surgical approach for the treament of liver tumors. Between december 2000 and June 2005, we performed 157 ablations in 102 patients. The patients suffered from HCC (n=72), CCC (n=4), colorectal metastases (n=27), or other metastases such as melanoma (n=2), breast cancer (n=2), ovary cancer (n=1), pancreatic cancer (n=2), neuroendocrine tumors (n=2), and fallopian tube (n=1). Eightyfour times, a single ablation for one tumor was sufficient. When more than one lesion was detected, we performed 2 (n=22), 3 (n=7), 4 (n=1), and 5(n=1) ablations at one time. The approach we used was percutaneously (n=54), laparoscopicly (n=15), or open surgically (46). The latter approach was combined with liver resection in 23 patients. Follow up was performed every 3 months using ultrasound or MRI. Of the 72 HCC patients 63 suffered from liver cirrhosis (Child A: n=36, Child B: n=25, Child C: n=2). Combined liver resection in cirrhosis was performed in 5 patients with Child A, in 2 patients with Child B, and none in Child C cirrhosis. The RFA in the 27 patients with colorectal metastases was performed during colorectal resection (n=3), or later on. In 9 of the patients with colorectal metastases, a liver resection was combined with RFA. The laparsocopic approach was used in 15 patients. The tumors were located on the liver surface and easy to reach with this approach. The percutaneous approach was used when the tumors were easy to visualize with ultrasound and easy to reach with the electrodes. We experienced a lost to follow up of 9.8%. The actuarial survival is 62%. The causes of death were liver failure (n=10) due to the underlaying disease, metastatic disease (n=6), pneumonia (n=2), renal failure (n=1), and pancreatic cancer (n=1). 54 out of 104 patients (52%) with follow up suffered from recurrent tumors. True local metastases were 22 (21%). The rest of the patients with recurrent tumors had lesions in new, non treated areas of the liver (n=32; 31%). The recurrence rate does not depend on the approach, if the RFA is safe. If feasible, we prefer the percutaneous approach, because it has the best comfort for the patient. In case of superficial tumors, the laparoscopic approach is of advantage to protect the adjacent organs from injury. After previous surgery or when liver resections have to be comb ined, we perform the open surgical approach which appears to be the safest, but causes less comfort for the patients.