RFA, chemotherapy combination improves survival rate of patients with liver metastases

Patients treated with radio-frequency ablation in conjunction with chemotherapy show significantly better survival rates than those receiving chemotherapy alone, according to a report presented at the RSNA meeting on Friday.

The study, conducted by Dr. Alice R. Gillams of Middlesex Hospital in London, U.K., included 190 patients with liver metastases selected from a pool of 358 patients originally diagnosed with colorectal cancer.

From this group of 190 patients, 90 had been treated with RFA and chemotherapy and 49 with chemotherapy alone. The remaining 51 underwent surgical resection or laser therapy.

Patients were divided into an optimal group with fewer than six metastases of less than 5 cm and no extrahepatic disease, and a nonoptimal group with six or more metastases, lesions larger than 6 cm, or extrahepatic disease.

Median survival rates were 33 months for patients undergoing RFA plus chemotherapy versus 18 months for chemotherapy alone. Survival for patients in the optimal group who received RFA and chemotherapy was 42 months with a five-year survival rate of 41%.

In the nonoptimal group, patients who had combined RFA/chemotherapy had a median survival rate of 31 months, while those treated with chemotherapy alone had a survival rate of 20 months. Chemotherapy results in this group surpassed those in previously published data, according to Gillams. More randomized controlled trials will be necessary, however, to compare both treatment approaches in patients with limited disease, she said.