Laser Ablation of Liver Metastases from Colorectal Cancer with MR Thermometry: 5-Year Survival

PURPOSE:To determine technical success, technique effectiveness, complications, and survival after laser ablation of liver metastases from colorectal cancer. MATERIALS AND METHODS: Eighty-seven consecutive patients (65 men. and 22 women; mean age, 62.8 years) with 180 liver metastases from colorectal carcinoma were included between 1998 and 2005. They underwent laser ablation with magnetic resonance (MR) in 170 sessions. Indications for laser ablation were locally unresectable tumors (1.6.1%), metastases in both liver lobes (34.5%), and refusal of surgery and/or general contraindications to surgery (49.4%). Technical success, technique effectiveness, and complication and survival rates were evaluated retrospectively. RESULTS: Technical success was achieved in 178 of 180 sessions (99%). Follow-up after 24-48 hours demonstrated an effectiveness rate of 85.6%. Local tumor progression rate was 10% after 6 months. Major complications included large pleural effusion, large, abscess, large pneumothorax, pleuritis with fever, intrahepatic hemorrhage, and biloma. Mean survival from the time of diagnosis of the primary tumor was 50.6 months for all patients treated (95% CI,44.9-56.3 months). Median survival time was 54 month, and survival rates were 95.7% at 1 year, 86.2% at 2 years, 72.4% at 3 years, 50.1% at 4 years, and 33.4% at 5 years. The mean survival time after the first treatment was 31.1 months (95% CI, 26.9-35.3 months). CONCLUSIONS: Laser ablation of liver metastases of colorectal cancer with MR thermometry appears safe and aging, direct comparison with other ablative modalities in a prospective efficacious. Although the are encouraging, direct comparison with other ablative modalities in prospective clinical trial would be necessary to definitely show one modality is superior.