American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer

Sandra L. Wong, Pamela B. Mangu, Michael A. Choti, Todd S. Crocenzi, Gerald D. Dodd, Gary S. Dorfman, Cathy Eng, Yuman Fong, Andrew F. Giusti, David Lu, Thomas A. Marsland, Rob Michelson, Graeme J. Poston, Deborah Schrag, Jerome Seidenfeld, Al B. Benson

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Abstract

Purpose: To review the evidence about the efficacy and utility of radiofrequency ablation (RFA) for hepatic metastases from colorectal cancer (CRHM). Methods: The American Society of Clinical Oncology (ASCO) convened a panel to conduct and analyze a comprehensive systematic review of the RFA literature from Medline and the Cochrane Collaboration Library. Results: Because data were considered insufficient to form the basis of a practice guideline, ASCO has instead published a clinical evidence review. The evidence is from single-arm, retrospective, and prospective trials. No randomized controlled trials have been included. The following three clinical issues were considered by the panel: the efficacy of surgical hepatic resection versus RFA for resectable tumors; the utility of RFA for unresectable tumors; and RFA approaches (open, laparoscopic, or percutaneous). Evidence suggests that hepatic resection improves overall survival (OS), particularly for patients with resectable tumors without extrahepatic disease. Careful patient and tumor selection is discussed at length in the literature. RFA investigators report a wide variability in the 5-year survival rate (14% to 55%) and local tumor recurrence rate (3.6% to 60%). The reported mortality rate was low (0% to 2%), and the major complications rate was commonly reported to be between 6% and 9%. RFA is currently performed with all three approaches. Conclusion: There is a compelling need for more research to determine the efficacy and utility of RFA to increase local recurrence-free, progression-free, and disease-free survival as well as OS for patients with CRHM. Clinical trials have established that hepatic resection can improve OS for patients with resectable CRHM.

Original languageEnglish (US)
Pages (from-to)493-508
Number of pages16
JournalJournal of Clinical Oncology
Volume28
Issue number3
DOIs
StatePublished - Jan 20 2010

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Colorectal Neoplasms
Neoplasm Metastasis
Liver
Neoplasms
Survival
Recurrence
Medical Oncology
Practice Guidelines
Patient Selection
Libraries
Disease-Free Survival
Survival Rate
Randomized Controlled Trials
Research Personnel
Clinical Trials
Mortality
Research

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Wong, Sandra L. ; Mangu, Pamela B. ; Choti, Michael A. ; Crocenzi, Todd S. ; Dodd, Gerald D. ; Dorfman, Gary S. ; Eng, Cathy ; Fong, Yuman ; Giusti, Andrew F. ; Lu, David ; Marsland, Thomas A. ; Michelson, Rob ; Poston, Graeme J. ; Schrag, Deborah ; Seidenfeld, Jerome ; Benson, Al B. / American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 3. pp. 493-508.
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title = "American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer",
abstract = "Purpose: To review the evidence about the efficacy and utility of radiofrequency ablation (RFA) for hepatic metastases from colorectal cancer (CRHM). Methods: The American Society of Clinical Oncology (ASCO) convened a panel to conduct and analyze a comprehensive systematic review of the RFA literature from Medline and the Cochrane Collaboration Library. Results: Because data were considered insufficient to form the basis of a practice guideline, ASCO has instead published a clinical evidence review. The evidence is from single-arm, retrospective, and prospective trials. No randomized controlled trials have been included. The following three clinical issues were considered by the panel: the efficacy of surgical hepatic resection versus RFA for resectable tumors; the utility of RFA for unresectable tumors; and RFA approaches (open, laparoscopic, or percutaneous). Evidence suggests that hepatic resection improves overall survival (OS), particularly for patients with resectable tumors without extrahepatic disease. Careful patient and tumor selection is discussed at length in the literature. RFA investigators report a wide variability in the 5-year survival rate (14{\%} to 55{\%}) and local tumor recurrence rate (3.6{\%} to 60{\%}). The reported mortality rate was low (0{\%} to 2{\%}), and the major complications rate was commonly reported to be between 6{\%} and 9{\%}. RFA is currently performed with all three approaches. Conclusion: There is a compelling need for more research to determine the efficacy and utility of RFA to increase local recurrence-free, progression-free, and disease-free survival as well as OS for patients with CRHM. Clinical trials have established that hepatic resection can improve OS for patients with resectable CRHM.",
author = "Wong, {Sandra L.} and Mangu, {Pamela B.} and Choti, {Michael A.} and Crocenzi, {Todd S.} and Dodd, {Gerald D.} and Dorfman, {Gary S.} and Cathy Eng and Yuman Fong and Giusti, {Andrew F.} and David Lu and Marsland, {Thomas A.} and Rob Michelson and Poston, {Graeme J.} and Deborah Schrag and Jerome Seidenfeld and Benson, {Al B.}",
year = "2010",
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doi = "10.1200/JCO.2009.23.4450",
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Wong, SL, Mangu, PB, Choti, MA, Crocenzi, TS, Dodd, GD, Dorfman, GS, Eng, C, Fong, Y, Giusti, AF, Lu, D, Marsland, TA, Michelson, R, Poston, GJ, Schrag, D, Seidenfeld, J & Benson, AB 2010, 'American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer', Journal of Clinical Oncology, vol. 28, no. 3, pp. 493-508. https://doi.org/10.1200/JCO.2009.23.4450

American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer. / Wong, Sandra L.; Mangu, Pamela B.; Choti, Michael A.; Crocenzi, Todd S.; Dodd, Gerald D.; Dorfman, Gary S.; Eng, Cathy; Fong, Yuman; Giusti, Andrew F.; Lu, David; Marsland, Thomas A.; Michelson, Rob; Poston, Graeme J.; Schrag, Deborah; Seidenfeld, Jerome; Benson, Al B.

In: Journal of Clinical Oncology, Vol. 28, No. 3, 20.01.2010, p. 493-508.

Research output: Contribution to journalReview article

TY - JOUR

T1 - American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer

AU - Wong, Sandra L.

AU - Mangu, Pamela B.

AU - Choti, Michael A.

AU - Crocenzi, Todd S.

AU - Dodd, Gerald D.

AU - Dorfman, Gary S.

AU - Eng, Cathy

AU - Fong, Yuman

AU - Giusti, Andrew F.

AU - Lu, David

AU - Marsland, Thomas A.

AU - Michelson, Rob

AU - Poston, Graeme J.

AU - Schrag, Deborah

AU - Seidenfeld, Jerome

AU - Benson, Al B.

PY - 2010/1/20

Y1 - 2010/1/20

N2 - Purpose: To review the evidence about the efficacy and utility of radiofrequency ablation (RFA) for hepatic metastases from colorectal cancer (CRHM). Methods: The American Society of Clinical Oncology (ASCO) convened a panel to conduct and analyze a comprehensive systematic review of the RFA literature from Medline and the Cochrane Collaboration Library. Results: Because data were considered insufficient to form the basis of a practice guideline, ASCO has instead published a clinical evidence review. The evidence is from single-arm, retrospective, and prospective trials. No randomized controlled trials have been included. The following three clinical issues were considered by the panel: the efficacy of surgical hepatic resection versus RFA for resectable tumors; the utility of RFA for unresectable tumors; and RFA approaches (open, laparoscopic, or percutaneous). Evidence suggests that hepatic resection improves overall survival (OS), particularly for patients with resectable tumors without extrahepatic disease. Careful patient and tumor selection is discussed at length in the literature. RFA investigators report a wide variability in the 5-year survival rate (14% to 55%) and local tumor recurrence rate (3.6% to 60%). The reported mortality rate was low (0% to 2%), and the major complications rate was commonly reported to be between 6% and 9%. RFA is currently performed with all three approaches. Conclusion: There is a compelling need for more research to determine the efficacy and utility of RFA to increase local recurrence-free, progression-free, and disease-free survival as well as OS for patients with CRHM. Clinical trials have established that hepatic resection can improve OS for patients with resectable CRHM.

AB - Purpose: To review the evidence about the efficacy and utility of radiofrequency ablation (RFA) for hepatic metastases from colorectal cancer (CRHM). Methods: The American Society of Clinical Oncology (ASCO) convened a panel to conduct and analyze a comprehensive systematic review of the RFA literature from Medline and the Cochrane Collaboration Library. Results: Because data were considered insufficient to form the basis of a practice guideline, ASCO has instead published a clinical evidence review. The evidence is from single-arm, retrospective, and prospective trials. No randomized controlled trials have been included. The following three clinical issues were considered by the panel: the efficacy of surgical hepatic resection versus RFA for resectable tumors; the utility of RFA for unresectable tumors; and RFA approaches (open, laparoscopic, or percutaneous). Evidence suggests that hepatic resection improves overall survival (OS), particularly for patients with resectable tumors without extrahepatic disease. Careful patient and tumor selection is discussed at length in the literature. RFA investigators report a wide variability in the 5-year survival rate (14% to 55%) and local tumor recurrence rate (3.6% to 60%). The reported mortality rate was low (0% to 2%), and the major complications rate was commonly reported to be between 6% and 9%. RFA is currently performed with all three approaches. Conclusion: There is a compelling need for more research to determine the efficacy and utility of RFA to increase local recurrence-free, progression-free, and disease-free survival as well as OS for patients with CRHM. Clinical trials have established that hepatic resection can improve OS for patients with resectable CRHM.

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M3 - Review article

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JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

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