Pusceddu, Claudio and Possanzini, Marco and Perra, Enrica and Meloni, F. and Profili, Stefano and Podda, Gabriele and Meloni, Giovanni Battista (2010) Radiofrequency ablation treatment in the pelvic cancer relapses of rectal carcinoma. European Journal of Surgical Oncology, Vol. 36 (10), p. 1022. ISSN 0748-7983. Article.
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Background: To evaluate retrospectively the technical feasibility, safety and efficacy of radiofrequency thermal ablation (RFA) in the treatment of recurrent rectal cancer that is painful, non-resectable and no longer susceptible to radiotherapy and chemotherapy.
Materials and Methods: Ten patients, average age 64 years, with pelvic recurrence of rectal carcinoma were treated with RFA to reduce pain and limit the progression of local disease. The lesion mean size was 4.7 cm(range of 3.2e9 cm). RFA was performed with computed tomography-guided percutaneous approach using local anaesthesia and conscious sedation in all patients. The therapeutic outcomes were evaluated by contrast- enhanced TC after 1, 3, 6 and 12 months. The absence of tumour enhancement on the TC image was considered to indicate complete tumour necrosis.
Results: Complete tumour necrosis was found in 3 patients, sub-total in the remaining 7. Complete pain relief was obtained in 6 patients and a significant reduction of pain in the remaining patients (mean VAS score from7.4 before treatment to 1.5 after treatment). Abscess formation in the pre-sacral space and a bladder-rectal fistula after RF treatment was observed in 2 patients. The mean follow-up was 40 months (7–55months); 7 patients died of local tumour or distant progression. Three patients are still alive with 2 of them disease free.
Conclusion: In selected cases, the RFA of pelvic recurrent rectal cancer can be considered a feasible and effective treatment in the control of pain and in the stabilisation of recidivism.
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