Margin Size is an Independent Predictor of Local Tumor Progression After Ablation of Colon Cancer Liver Metastases

Journal Article · Fri Feb 15 00:00:00 EST 2013 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-012-0377-1· OSTI ID:22156514

Xiaodong, Wang; Erinjeri, Joseph P.; Petre, Elena N. ^[1]; Gonen, Mithat ^[2]; Do, Kinh G. ^[3]; Brown, Karen T.; Covey, Anne M.; Brody, Lynn A.; Alago, William; Thornton, Raymond H. ^[1]; Kemeny, Nancy E. ^[4]; Solomon, Stephen B. ^[1]

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1. Memorial Sloan-Kettering Cancer Center, Section of Interventional Radiology, Department of Radiology (United States)
2. Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States)
3. Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)
4. Memorial Sloan-Kettering Cancer Center, Department of Medicine (United States)

This study was designed to evaluate the relationship between the minimal margin size and local tumor progression (LTP) following CT-guided radiofrequency ablation (RFA) of colorectal cancer liver metastases (CLM). An institutional review board-approved, HIPPA-compliant review identified 73 patients with 94 previously untreated CLM that underwent RFA between March 2003 and May 2010, resulting in an ablation zone completely covering the tumor 4-8 weeks after RFA dynamic CT. Comparing the pre- with the post-RFA CT, the minimal margin size was categorized to 0, 1-5, 6-10, and 11-15 mm. Follow-up included CT every 2-4 months. Kaplan-Meier methodology and Cox regression analysis were used to evaluate the effect of the minimal margin size, tumor location, size, and proximity to a vessel on LTP. Forty-five of 94 (47.9 %) CLM progressed locally. Median LTP-free survival (LPFS) was 16 months. Two-year LPFS rates for ablated CLM with minimal margin of 0, 1-5 mm, 6-10 mm, 11-15 mm were 26, 46, 74, and 80 % (p < 0.011). Minimal margin (p = 0.002) and tumor size (p = 0.028) were independent risk factors for LTP. The risk for LTP decreased by 46 % for each 5-mm increase in minimal margin size, whereas each additional 5-mm increase in tumor size increased the risk of LTP by 22 %. An ablation zone with a minimal margin uniformly larger than 5 mm 4-8 weeks postablation CT is associated with the best local tumor control.

• OSTI ID: 22156514
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 36, Issue 1; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABLATION
COMPARATIVE EVALUATIONS
CONTROL
LIVER
METASTASES
PATIENTS
RADIOWAVE RADIATION
REGRESSION ANALYSIS