Using radiofrequency energy or liquid nitrogen to remove inoperable liver tumors can extend patient survival, according to new researchers at Wake Forest University Baptist Medical Center.
Results of the study were reported at the Society of Surgery for the Alimentary Tract in Chicago on May 16.
“Currently with the latest chemotherapy treatments, patients with inoperable liver tumors resulting from colorectal cancer have a median survival of 20 months,” said Perry Shen, M.D., assistant professor of surgical oncology at Wake Forest University School of Medicine, part of Wake Forest Baptist. “Our study was designed to see if ablation therapy could improve those survival times.”
Shen and colleagues at Wake Forest Baptist studied 150 patients between 1994 and 2005 with liver cancer that had spread from colorectal cancer. Patients were treated with surgery when possible. Inoperable tumors were treated with ablation or a combination of surgery and ablation.
The median survival time for patients who had surgery alone was 39 months. For patients having ablation therapy, the median survival was 33 months – compared to the 20-month median previously reported for patients whose tumors were treated with chemotherapy.
However, there was a significant difference between the two groups in disease recurrence, especially in the liver. The median time to recurrence of liver disease in the ablation group was 11 months and in the surgery group it was 17 months. The use of chemotherapy in combination with these therapies was found to improve overall survival.
The overall 3-year survival rate for the patients was 51 percent. Patients with inoperable disease had significantly more tumors and more evidence of disease that had spread beyond the liver. There was no significant difference in overall survival for patients undergoing surgery versus those undergoing ablation or the ablation/surgery combination.
“The results of this study show that tumor ablation therapy for inoperable liver metastases from colorectal cancer can extend survival for patients with a poor prognosis,” said Shen.
The addition of chemotherapy after surgery or ablation may offer the best results.
“Whether tumor ablation is equal to liver surgery in the long term will require further investigation,” Shen said.
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