Radiofrequency ablation for recurrent pelvic cancer

Abstract

Objective: Local recurrence of pelvic cancer is a therapeutic challenge. The purpose of the study was to evaluate radiofrequency ablation (RFA, intra-operative or CT-guided) for the treatment of pelvic recurrence in patients not eligible for curative surgical resection.

Method: Charts of all patients treated for pelvic recurrence by RFA between March 2004 and March 2005 were reviewed.

Results: Eight patients (two females) had RFA for inoperable local recurrence [rectal adenocarcinoma (six) and sarcoma (two)]. Surgical resection of the primary tumour had been performed at a median age of 50.2 (36.7-61.6) years. Recurrence occurred after a median of 49.5 (11.7-63.5) months. The mean size of the recurrence was 33.4 (20-45) mm. RFA was given on a median number of two occasions (1-3). Complications occurred in six patients including minor pain [pelvic (six); sciatic nerve irritation (four)]; ureteric obstruction requiring stenting (two) and colo-vesical fistula (one), requiring ileal urinary diversion. After a median follow-up of 18.2 months (11-32), six patients were still alive. Patients, who had experienced pain prior to RFA were pain-free. Five patients showed evidence of further tumour growth but were asymptomatic.

Conclusion: Radiofrequency ablation is a feasible therapeutic option for recurrent pelvic cancer. It allows good symptom control in patients with pain but morbidity is high.