Objective : Describe the safety and efficacy of percutaneous ablation of colorectal liver metastases following hepatic arterial infusion pump chemotherapy (HAIP)
Methods : A retrospective review of patients with metastatic colorectal cancer that underwent percutaneous ablation following HAIP between 2006-2017 at a single institution was performed. 70 patients underwent HAIP treatment for metastatic colorectal cancer. Of these, 9 patients underwent 15 ablation sessions after HAIP. A total of 25 liver lesions were treated. The study cohort included 7 men and 2 women. Median age of the population was 49 years (range 41-78). The electronic medical record was used to assess 30 day complication rate and overall survival. Imaging studies were reviewed to assess local response and recurrence rates.
Results : Technical success was achieved in all patients. All patients were discharged less than 24 hours after ablation. No 30 day major or minor complications were noted. Median follow-up was 20 months (range 8-116 months). Median number of lesions treated was 2 (range 1-3). Median size of lesions treated was 2 cm (range 0.9-5.3 cm). Microwave ablation and radiofrequency ablation were used in 12 and 3 procedures, respectively. Two patients had local recurrence after ablation. The size of the recurrent lesions at the time of ablation was 3.6 cm and 5.3 cm, respectively. Local recurrence was treated with repeat ablation in one patient and surgical resection in the other patient. Median time to local recurrence was 303 days (range 230-376). Median survival of the population was 69 months from time of ablation (range 22-116).
Conclusions : Percutaneous ablation of colorectal cancer liver metastases following hepatic arterial infusion pump chemotherapy appears safe and effective. Long term survival was seen in this population.