CHICAGO - Patients who undergo laser ablation of liver metastases can look forward to a prognosis "at least as good" as those individuals with metastatic cancer who undergo surgery with curative intent, researchers reported Tuesday at the 2005 RSNA meeting.
"Those who undergo surgery have a median survival of 3.4 to 4.5 years, but patients who undergo ablation treatment have a median survival of around five years," said Dr. Martin Mack, associate professor of diagnostic and interventional radiology at the University of Frankfurt in Germany.
With the ablation technique, formally known as laser-induced thermotherapy, doctors use magnetic resonance imaging to precisely locate a tumor and then guide a laser probe into the tumor. The laser is turned on and its energy destroys the lesion.
In addition to similar or better survival in patients who select the ablation technique over open surgery in potentially curative cases, Mack said the laser ablation treatment offers a number of other advantages:
It can be repeated as often as needed.
It can be performed on an outpatient basis. While some patients who have open surgery may require a week in the hospital to recover, Mack said his patients are discharged six hours after the laser ablation procedure.
Mortality and morbidity are lower with the ablation method. Mortality in the open surgery procedure can reach 3% to 4% of the patients. For his patients, Mack reported that mortality is about 0.2%. Morbidity for open surgery can be as high as 30%, compared to 2% for the ablation technique.
Few studies have compared the techniques head-to-head, Mack said. Historical comparisons of similar patient populations showed that at 4.5 years about 45% of 111 patients who underwent the laser ablation procedure survived. Those patients had potentially curable disease, but refused open surgery.
Of 226 patients who underwent open curative surgery, about 35% were alive at 4.5 years. Among 646 patients with colorectal cancer metastases to the liver who underwent potentially curative ablation procedures, about 35% also survived 4.5 years.
By Edward Susman
AuntMinnie.com contributing writer
November 30, 2005
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