ENDOSCOPIC ULTRASOUND (EUS) GUIDED RADIOFREQUENCY ABLATION (RFA) FOR LIVER METASTASES: PRELIMINARY EXPERIENCE IN 14 CONSECUTIVE PATIENTS

Aims Loco-regional treatments for liver metastasis from colorectal and pancreatic neuroendocrine (NET) tumors are based on surgical resection and/or transcutaneous RFA. Local eradication of metastasis from pancreatic duct adenocarcinoma (PADC) is more controversial. We aimed to investigate the feasibility and safety of EUS guided RFA in a highly selected group of patients with less than 4 liver metastases (LM).

Methods Prospective series of patients treated with EUS-guided RFA. A 150cm, 19 gauge needle-electrode connected to a RF generator settled to 50w was used. Technical success was defined as > 80% ablation of LM on post RFA CT.

Results From December 2017 to September 2020, fourteenth patients (8 men), median age 64(31-75) were included. Primary tumors were PADC in 12 patients, pancreatic NET and colon cancer in 1patient. 24 LM were treated, 8 on right liver lobe; median size 20mm (8-55). Technical success was achieved for 15 of the 20 LM evaluated. Post RFA median survival in PADC patients was 6 months (1.5-41) while overall median survival was 16 months (2.5-51), the 2 other patients were still alive 13 and 41months after RFA. Two complications occurred, jaundice treated by PTC and asymptomatic gallbladder hematoma in 1patient each.

Conclusions In selected patients, EUS guided RFA for liver metastasis was feasible and safe with high initial technical success. Right liver lobe metastases can be treated as metastasis elsewhere in liver. The unusually prolonged observed survival should be confirmed by larger controlled studies as potential place of EUS-guided RFA in combination treatment for CC liver metastasis

Publication History

Article published online:
14 April 2022