Kolorektal Kanser Metastazlarının Tedavisinde Radyofrekans Ablasyon: Uzun Dönem Klinik Sonuçları

Abstract

Radiofrequency Ablation in the Management of Colorectal cancer metastasis: Long term outcomes. Hacettepe University, School of Medicine, Department of Radiology. Thesis. Ankara. 2013 Radiofrequency ablation (RFA), one of the thermal ablation methods, is a promising method in the management of colorectal cancer metastasis among those, alternative to surgical resection. The aim of this study is to determine the therapeutic efficiency and long-term outcome of RFA treatment, and to evaluate the risk factors. 59 patients, of whom 18 (30. 5%) were female and 41 were male (69.5%), have undergone RFA therapy between October 2001 and February 2012. 30 of the patients had a solitary lesion and 29 patients had multiple lesions. In total 148 lesion were ablated including; 116 lesions ablated at the initial session following diagnosis, 12 recurrent lesion after initial RFA treatment and 20 new lesion treated during follow-up. Average number of treatment sessions per patient was 2. 5. Lesion sizes varied between 1 to 6 cm (mean 2.45 cm, median 2 cm, <2 cm, n=80; 2-5 cm, n=56, >5 cm, n=12 ). Statistical analysis was done with Kaplan-Meier method. Accordingly, 1-, 3- and 5- year survival rates were 94.9%, 52.5% and 40.6%, respectively. Median follow-up period was 20 months. Tumor free period was 18.5 months and 1-, 3- and 5- year tumor free survival rates were 44. 0%, 10. 2% ve 6. 7 % respectively. Patient age, gender, presence of metastases at presentation, local recurrences have no effect on survival rate. However, having solitary or multiple lesions at initial presentation and extrahepatic recurrence, found to have a significant effect on overall survival rate. As a conclusion, for patients with non-resectable hepatic metastases of colorectal cancer, RFA is a safe option in a multimodal treatment concept and may lead to an improvement in survival.