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Medline ® Abstract for Reference 54

of 'The role of local therapies in metastatic breast cancer'

Combined resection and radiofrequency ablation for advanced hepatic malignancies: results in 172 patients.
Pawlik TM, Izzo F, Cohen DS, Morris JS, Curley SA
Ann Surg Oncol. 2003;10(9):1059.
BACKGROUND: Resection combined with radiofrequency ablation (RFA) is a novel approach in patients who are otherwise unresectable. The objective of this study was to investigate the safety and efficacy of hepatic resection combined with RFA.
METHODS: Patients with multifocal hepatic malignancies were treated with surgical resection combined with RFA. All patients were followed prospectively to assess complications, treatment response, and recurrence.
RESULTS: Seven hundred thirty seven tumors in 172 patients were treated (124 with colorectal metastases; 48 with noncolorectal metastases). RFA was used to treat 350 tumors. Combined modality treatment was well tolerated with low operative times and minimal blood loss. The postoperative complication rate was 19.8% with a mortality rate of 2.3%. At a median follow-up of 21.3 months, tumors had recurred in 98 patients (56.9%). Failure at the RFA site was uncommon (2.3%). A combined total number of tumors treated with resection and RFA>10 was associated with a faster time to recurrence (P =.02). The median actuarial survival time was 45.5 months. Patients with noncolorectal metastases and those with less operative blood loss had an improved survival (P =.03 and P =.04, respectively), whereas radiofrequency ablating a lesion>3 cm adversely impacted survival (HR = 1.85, P =.04).
CONCLUSIONS: Resection combined with RFA provides a surgical option to a group of patients with liver metastases who traditionally are unresectable, and may increase long-term survival.
Department of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas 77030, USA.