Efficacy and feasibility of radiofrequency ablation for liver metastases from gastric adenocarcinoma

Abstract

Purpose: Optimal treatment for liver metastases from gastric cancer remains a matter of debate. The aim of our study is to evaluate the efficacy of radiofrequency ablation (RFA) for the treatment of liver-only metastases from gastric adenocarcinoma. Materials and methods: We retrospectively reviewed medical records of 29 patients who developed liver-only metastases from gastric adenocarcinoma and subsequently underwent gastric resection and RFA (n 20) or gastric resection and systemic chemotherapy (n 9) between January 1995 and February 2008. Overall survival was estimated using the Kaplan-Meier method, and was compared using the log rank test to evaluate RFA efficacy. Results: Twenty patients who underwent RFA showed a median overall survival of 30.7 months (range: 2.9 to 90.9 months), a median progression-free survival of 6.8 months (range: 0.8 to 45.2 months), and median overall one-, three-, and five-year survival rates were 66.8, 40.1, and 16.1 respectively. The RFA group showed a 76 decreased death rate compared to the chemotherapy-only group (30.7 months versus 7 months, hazard ratio, 0.24; p 0.004). Most patients tolerated RFA well, and complications were found to be minor (transient fever (20) and/or right upper quadrant pain (25)). One case of treatment-related death occurred due to sepsis that originated from a liver abscess at the ablation site. Conclusions: The data suggest that a use of RFA as a liver-directed treatment may provide greater survival benefit than chemotherapy and is an alternative option for the treatment of liver-only metastases from gastric cancer. © 2010 Informa UK Ltd.