Alison R. Gillams MBCHB, Presenter: Nothing to Disclose

William Robert Lees MBBS, Abstract Co-Author: Nothing to Disclose

Colorectal liver metastases are the most common secondary hepatic malignancy to be treated by local ablation techniques. Most groups will treat patients with 5 or fewer lesions, maximum diameter 5 cm. The European Organisation for Research and Treatment of Cancer) EORTC sponsored "Chemotherapy and local ablation versus chemotherapy alone in patients with inoperable colorectal liver metastases" (CLOCC) trial uses different acceptance criteria i.e. those with 9 or fewer lesions, maximum diameter 4cm. We have treated 190 patients with radiofrequency ablation (RFA) and have analysed our data using traditional and CLOCC criteria.

Indications for RFA were patients with limited liver disease who cannot undergo liver resection because of disease distribution, location, co-morbidity, inadequate residual functioning liver parenchyma or patient preference. Our standard treatment technique is an US and CT guided and monitored ablation under general anaesthesia using single or cluster cool-tip electrodes. Multiple overlapping ablations are performed for all but the smallest < 1cm lesions. Number and maximum diameter of lesions on portal venous contrast enhanced CT scans, time of ablation, time of diagnosis of liver metastases, date of death or last follow-up were recorded.

Of 190 patients, 86 fulfilled CLOCC criteria and 86 fulfilled traditional criteria. 52 patients were common to both groups, 34 were not. Survival from the first thermal ablation for the CLOCC group was a median, 1-year, 3- year and 5-year of 31 months, 95%, 30% and 26% and from the diagnosis of liver metastases 38 months, 100%, 62% and 30%. This did not differ substantially from survival for patients with traditional criteria which was 31 months, 92%, 35% and 26% and 44 months, 99%, 61% and 34%.

Although the CLOCC criteria increased the number of metastases to be ablated, the overall survival results were similar.

Gillams, A, Lees, W, 190 Patients with Colorectal Liver Metastases Treated with Radiofrequency Ablation: Analysis of Survival Using the CLOCC Acceptance Criteria.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4414447.html