Occlusion of the vein adjacent to colorectal cancer liver metastasis as a way to increase the radicality of percutaneous radiofrequency thermal ablation

Abstract

Objective. To evaluate the effectiveness of preoperative coagulation of the vein adjacent to a tumor nodule in sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer.Materials and methods. To address the issue, we compared the results of sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer in 27 patients (aged 60.5 (58; 68) years) without prior coagulation of the adjacent vein (control group) and 26 patients (62.0 (60; 74)) with prior coagulation of the adjacent vein (experimental group).Results. Lower incidence of residual tumor in the ablation area in the patients with prior coagulation of the adjacent vein (14.3 % vs. 29 % of the patients in the control group) and a higher relapse-free survival of such patients (65.2 % vs. 53.6 % and 55.6 % vs. 33.3 %) were reported as compared to the group without prior coagulation of the adjacent vein (after 6 and 12 months, respectively).Conclusion. Preoperative coagulation of the vein adjacent to colorectal cancer liver metastasis allows reducing the effect of heat removal from the RFA zone, thereby contributing to higher radicality of the treatment and resulting both in a lower incidence of residual tumor in the ablation zone and a higher relapse-free survivalof patients, notably without signifcant concomitant changes in the affected part of the liver (segment atrophy).