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. 2012 Feb;18(2):CR88-92.
doi: 10.12659/msm.882463.

Thermal ablation of unresectable liver tumors: factors associated with partial ablation and the impact on long-term survival

Philipp Wiggermann  1 , Ralf Puls, Andrej Vasilj, Dominik Sieroń, Andreas G Schreyer, Ernst-Michael Jung, Wojciech Wawrzynek, Christian Stroszczynski
Affiliations

Thermal ablation of unresectable liver tumors: factors associated with partial ablation and the impact on long-term survival

Philipp Wiggermann et al. Med Sci Monit. 2012 Feb.

Abstract

Background: Thermal ablation procedures, including radiofrequency ablation (RFA) or laser-induced interstitial thermotherapy (LITT), are now well established in the treatment of malignant unresectable hepatic tumors. But the impact of partial ablation (PA) on long-term survival following computed tomography (CT)-guided radiofrequency ablation and laser- induced interstitial thermotherapy of unresectable malignant liver lesions and the associated risk factors of PA remain partially unknown.

Material/methods: This study included 254 liver tumors in 91 consecutive patients (66 men and 25 women; age 60.9 ± 10.4 years; mean tumor size 25 ± 14 mm [range 5-70 mm]) who underwent thermal ablation (RFA or LITT) between January 2000 and December 2007. Mean follow-up period was 21.1 month (range 1-69 months). Survival rate and local progression-free survival (PFS) were calculated for patients with complete ablation (CA) vs. patients with partial ablation (PA) to assess the impact on long-term survival.

Results: Median survival after CA was 47 months compared to 25 months after PA (P=0.04). The corresponding 5-year survival rates were 44% vs. 20%. Median PFS for CA was 11 months compared to 7 months for PA (P=0.118). The sole statistically significant risk factor for PA was tumor size (>30 mm; P=0.0003). Sustained complete ablation was achieved in 71% of lesions ≤ 30 mm vs. 47% of lesions >30 mm.

Conclusions: We conclude that achievement of complete ablation is a highly important predictor of long-term survival and that tumor size is by far the most important predictor of the likelihood of achieving complete ablation.

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Figures

Figure 1
Figure 1
Cumulative survival curves for complete and partial ablation calculated by the Kaplan-Meier method.
Figure 2
Figure 2
Time to local progress for patients with complete or partial ablation. Median time to progression for PA was 7 months, compared to 11 months for patients with a CA.
See this image and copyright information in PMC

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