Radiofrequency ablation of liver metastasis in patients with locally controlled pancreatic ductal adenocarcinoma

Purpose: To evaluate retrospectively the role of radiofrequency (RF) ablation for liver metastases arising from pancreatic ductal adenocarcinoma simultaneously with pancreatic resection or after curative resection in patient survival. Materials and Methods: RF ablation of liver metastases was performed on 34 patients with pancreatic ductal adenocarcinoma postoperatively after pancreatectomy or intraoperatively at pancreatectomy between December 2002 and June 2009. Criteria for RF ablation were liver metastasis ≤ 3 cm diameter in size, five or fewer lesions, and no definite suspicious lesion other than liver metastasis. Patient survival was assessed by the Kaplan-Meier method, and prognostic factors were analyzed. Results: Of the patients receiving RF ablation treatment (n = 34), 18 underwent one session of RF ablation, and 16 underwent more than one session. In each session, all the targeted lesions were successfully ablated by ultrasound-guided RF ablation. Median duration of follow-up was 15 months (range, 3-65 mo). The interval between pancreatic resection and liver metastasis was 3 months (range, 0-33 mo). Median survival time after liver metastasis was 14 months. Univariate analysis of factors affecting survival showed that better patient survival after RF ablation was associated with a single, < 2 cm diameter liver metastasis (P =.007) and well or moderate differentiation (P =.032). In multivariate analysis, a single < 2 cm diameter liver metastasis and good or moderate differentiation were independent predictors for longer patient survival (P =.027, P =.016). Conclusions: RF ablation in liver metastasis occurring after locally controlled pancreatic ductal adenocarcinoma can be a safe and feasible strategy for extending survival in selected patients.