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| |  Thermosurgical Ablation May Benefit Some Patients With Difficult-to-Treat Abdominopelvic Malignancies: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 7, 2010 -- Combined open radiofrequency ablation and surgical debulking of otherwise inoperable primary or recurrent/metastatic abdominopelvic malignancies may moderately improve survival in carefully selected patients, researchers said here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). “Patients with locally advanced, inoperable primary or secondary abdominopelvic malignancies can present a unique challenge to the treating physician, particularly if they develop significant tumour-related symptoms without evidence of widespread disease and/or major comorbidities,” said Csaba Gajdos, MD, then with the University of Colorado, Aurora, Colorado, now with the University of Michigan, Ann Arbor, Michigan. “These usually sizable tumours frequently involve important structures, such as the vertebral column, pelvic sidewall, the aorta, or root of the mesentery which cannot be resected without major postoperative morbidity and mortality.” For this reason, his team decided to apply the experience gained with thermo-ablation in otherwise inoperable metastatic hepatic malignancies to this unique group of patients. The study included 16 patients with primary tumours and 34 patients with a recurrent/metastatic malignancy, all of whom were undergoing ablation for inoperable abdominopelvic malignancies by conventional methods. Patients were selected for combined open debulking if they had a dominant mass causing significant symptoms. All tumours were debulked with a combination of serial application of conventional radiofrequency probe and surgical curettage/resection. At follow-up (September 2009), 22 patients remained alive and 28 had died. The median survival in patients who had died was 9.5 months, and the median survival in patients who remained alive was 22 months. The survival for the entire study population was 18%. Patients with ablated primary tumours had a survival advantage over patients who had ablation for recurrent metastatic disease. Overall, patients with primary tumours had a 5-year survival of 41% while there were no 5-year survivors in the recurrent/metastatic disease group (P = .007). The investigators said that a larger study might be needed to identify ways to improve patient selection, refine their surgical technique, and further minimise complications. [Presentation title: Open Thermosurgical Ablation of Inoperable Primary or Recurrent Metastatic Abdomino-pelvic Malignancies. Abstract P173]
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