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| LETTER TO EDITOR |
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| Year : 2008 | Volume
: 4
| Issue : 3 | Page : 145 |
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Radiofrequency ablation in liver metastasis: Authors' reply
GK Rath1, PK Julka1, S Thulkar2, DN Sharma1, Amit Bahl1, S Bhatnagar3
1 Department of Radiation Oncology, DRBRA Institute, Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029, India
2 Department of Radiodiagnosis, DRBRA Institute, Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029, India
3 Department of Anesthiology, DRBRA Institute, Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029, India
| Date of Web Publication | 27-Sep-2008 |
Correspondence Address:
Amit Bahl
Department of Radiation Oncology, DRBRA IRCH, AIIMS, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-1482.43153
How to cite this article:
Rath G K, Julka P K, Thulkar S, Sharma D N, Bahl A, Bhatnagar S. Radiofrequency ablation in liver metastasis: Authors' reply. J Can Res Ther 2008;4:145 |
Sir,
We are pleased to know about the interest shown by readers in our study. Radiofrequency ablation (RFA) is now increasingly being accepted as a therapeutic modality to treat cancer patients presenting with liver metastasis. [1],[2] In our study [3] the majority of patients treated were those presenting with noncolorectal primary cancers. The primary site included breast (65%), cervix (10%), sarcomas (10%), lung (10%) and colorectum (5%). We would like to clarify that all patients in our study underwent surgical evaluation prior to RFA, but were considered ineligible for surgery for various reasons like poor general condition, associated co-morbid conditions, presence of two metastatic lesions in different lobes of liver and patient's refusal to undergo surgery. All patients had their primary tumor under control at the time of undergoing RFA, which was done with a curative intent. Though surgical resection is traditionally offered to patients with liver metastasis from colorectal cancers, its role can be debated in metastasis from other primary sites. Moreover RFA in liver metastasis is producing results comparable to surgical resection and can be an alternative to surgery. A recent study by Leblanc F et al . [4] compared surgical resection with RFA in patients with liver metastases. After two years of follow-up, the local recurrence rate was similar in the RFA and resection groups with similar survival rates. Another study found a comparable three-year survival rate for patients with solitary liver metastases treated with resection versus radiofrequency ablation (55.4 versus 52.6%). [5] RFA is a minimally invasive procedure as compared to surgical resection, with excellent patient compliance, minimum morbidity and requiring only day-care facilities or overnight stay. Results of smaller trials comparing the two show an equivalent local control and survival rate. [4],[5] A larger randomized trial with adequate follow-up is called for to answer the question of equivalence of the two modalities. We strongly feel that radiofrequency ablation is a viable newer treatment alternative to surgical resection for treating both colorectal and noncolorectal liver metastasis.
| > References | |  |
| 1. | Rossi P, Danza FM, Stolfi VM, Lorezo N Di, Coscarella G, Manzelli A, et al . Radiofrequency interstitial thermal ablation of metastatic liver tumors. Int Congr Series 2001;1230:1070-5. 
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| 2. | Livraghi T, Solbiati L, Meloni F, Ierace T, Goldberg SN, Gazelle GS. Percutaneous radiofrequency ablation of liver metastases in potential candidates for resection: The "Test-of-Time" approach. Cancer 2003;97:3027-35.
[PUBMED] [FULLTEXT] |
| 3. | Rath GK, Julka PK, Thulkar S, Sharma DN, Bahl A, Bhatnagar S. Radiofrequency ablation of hepatic metastasis: Results of treatment in forty patients. J Cancer Res Ther 2008;4:14-7.
[PUBMED] [FULLTEXT] |
| 4. | Leblanc F, Fonck M, Brunet R, Becouarn Y, Mathoulin-Pιlissier S, Evrard S. Comparison of hepatic recurrences after resection or intraoperative radiofrequency ablation indicated by size and topographical characteristics of the metastases. Eur J Surg Oncol 2008;34:185-90.
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| 5. | Oshowo A, Gillams A, Harrison E, Lees WR, Taylor I. Comparison of resection and radiofrequency ablation for treatment of solitary colorectal liver metastases. Br J Surg 2003;90:1240-3.
[PUBMED] [FULLTEXT] |
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