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Sequential radiofrequency ablation and surgical debulking for unresectable colorectal carcinoma: Thermo‐surgical ablation
Author(s) -
Ripley R. Taylor,
Gajdos Csaba,
Reppert Amy E.,
MacDermott Tracey,
McCarter Martin D.,
Pearlman Nathan W.
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23211
Subject(s) - medicine , debulking , surgery , radiofrequency ablation , colorectal cancer , tumor debulking , ablation , carcinoma , cancer , chemotherapy , ovarian cancer
Background and Objectives Despite decreasing frequency, local recurrences of unresectable colorectal cancer (CRC) remain difficult problems. These patients have few treatment options with conventional therapy. Preliminary results of sequential radiofrequency ablation (RFA) and surgical debulking (thermo‐surgical ablation) suggest this technique may have benefit. Methods We reviewed a prospective database of patients undergoing thermo‐surgical ablation for unresectable colorectal carcinoma from 2003 to 2011. Results Sixteen patients were treated with unresectable, recurrent abdomino‐pelvic colorectal carcinoma: 11 in pelvis; 4 with isolated aortic/retroperitoneal disease; and 1 with pelvic and peri‐adrenal/retroperitoneal disease. Eleven patients had recurrent rectal cancer and five had recurrent colon cancer. Median overall and 3‐year actuarial survivals were 15 months and 24%, respectively. Median and 3‐year PFS was 12 months and 19%, respectively. Three patients without disease have survived 0.75, 4.0, and 7.0 years. Two patients died at 5.0 and 5.5 years. A disease‐free interval (DFI) of >24 months after initial resection was associated with longer overall survival (60 months vs. 4 months; P = 0.001). Conclusions Thermo‐surgical debulking appears to have a role in the treatment of some patients with recurrent, unresectable CRC; those patients with DFI >24 months after initial surgery benefited the most. J. Surg. Oncol. 2013;107:144–147. © 2012 Wiley Periodicals, Inc.