ABSTRACT
Surgical resection is the standard of care for colorectal metastases isolated to the liver. However, only 10-25% are eligible for resection because of extent and location of the disease in the liver or concurrent medical conditions. Severe series have shown that radiofrequency ablation [RFA] can result in tumor eradication in properly selected candidates. The purpose of this study was to determine the efficacy of RFA for treatment of such lesions. Thirty patients with documented colorectal liver metastases who met the following criteria were considered for RFA: metastases confined to the liver; judged irresectable due to technical considerations or co-morbidity, number of metastatic deposits no greater than 5; and size less than 10 cm. Median follow-up was 26 [range 9-63] months. Overall 1-and 2-year survival rates were 76 and 61% respectively. Median survival was 32 months. Disease-free survival at 1 year was 35% at 2 years 7%. Six patients developed recurrence at the site of RFA; given that the total number of RFA-treated lesions was 69 the local recurrence rate was 9%. RFA can achieve effective local treatment for patients with colorectal liver metastases who were considered unsuitable for surgical treatment
Subject(s)
Humans , Male , Female , Catheter Ablation/methods , Colorectal Neoplasms , Mortality , Survival RateABSTRACT
The aim of the study was to verify the frequency of the immunohistochemical overexpression of her-2/neu and p53 in gastric carcinoma and their relation to the other clinicopathological features and the impact on survival rates. A total of 93 patients of gastric carcinoma, who had a potential curative surgery in the period from 2001-2007 and with representative paraffin blocks, and sufficient follow-up data were included in this study. They were arrayed and evaluated for protein marker overexpression using tissue microarray [TMA]. Patients, tumor and treatment characteristics were collected from the patients files. The possible prognostic significance of p53 and her-2/neu over expression and different clinicopathological features on survival rates were explored. Twenty four [25.8%] cases were her-2/neu and p53 positive. None of the examined clinicopathologic factors had a significant relation to her-2/neu overexpression p53 was overexpressed in intestinal type, 14/34 [41.2%], more than in diffuse type, 10/59 [16.9%], [p= 0.01]. There was no relation between the overexpression of p53 and her-2/neu. The median survival period was 17.7 months. The survival rates at 12 months were 64.2%, 52.2%, 55.6% and 45.0% for overall [OS], local control [LC], metastasis free survival [MFS] and disease free survival [DPS] rates, respectively. Patients with advanced stages had a significantly lower OS and MFS. Age above 57 years was associated with significantly lower OS, LC, MFS and DPS. Patients who received radiotherapy had significantly higher OS, LC, MFS and DPS. None of the survival rates had been affected by the overexpression of p53, or her-2/neu. Although, this study failed to show any prognostic effect of p53 and her-2/neu on survival rates, we may suggest that p53 overexpression may play a role in the pathogenesis of intestinal gastric adenocarcinoma. It could also demonstrate the significantly improved survival rates with adjuvant chemoradiation. Also, TMA is a useful technique for rapid identification of protein expression profiles using minimal samples from archived tissues