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Magnetic Resonance–Guided Laser-Induced Interstitial Thermotherapy of Breast Cancer Liver Metastases and Other Noncolorectal Cancer Liver Metastases: An Analysis of Prognostic Factors for Long-Term Survival and Progression-Free Survival

Vogl, Thomas Josef MD*; Freier, Verena MED*; Nour-Eldin, Nour-Eldin Abdelrehim MD, MSc*†; Eichler, Katrin MD*; Zangos, Stephan MD*; Naguib, Nagy Naguib Naeem MSc*‡

doi: 10.1097/RLI.0b013e31828328d7
Original Articles

Purpose The purpose of this study was the evaluation of prognostic factors for long-term survival and progression-free survival (PFS) after treatment of noncolorectal cancer liver metastases through MR-guided laser-induced thermotherapy (LITT).

Patients and Methods We included 401 patients (mean age, 57.3 years) with liver metastases from different primary tumors who were treated with LITT. Long-term survival and progression-free-survival rates were evaluated using the Kaplan-Meier method. A Cox regression model tested different parameters that could be of prognostic value. The tested prognostic factors were as follows: the location of primary tumor, TNM classification, extrahepatic metastases, hepatic resection or neoadjuvant transarterial chemoembolization or systemic chemotherapy before LITT, the number of initial metastases, the volume of metastases, and the quotient of total volumes of metastases and necroses per patient.

Results The median survival was 37.6 months starting from the date of LITT. The 1-, 2-, 3-, 4-, and 5-year survival rates were 86.5%, 67.2%, 51.9%, 39.9%, and 33.4%, respectively. The median PFS was 12.2 months. The 1-, 2-, 3-, 4-, and 5-year PFS rates were 50.6%, 33.8%, 26%, 20.4%, and 17%, respectively. The initial number of metastases, the volumes of metastases, and the quotient of the volumes of metastases and necroses influenced the long-term survival and the PFS.

Conclusions Laser-induced thermotherapy is a minimally invasive method in the treatment of hepatic metastases of noncolorectal cancer, and it shows good results in long-term survival and PFS. The initial number of metastases and their volume are the most important prognostic factors. The status of the lymph nodes, the existence of other extrahepatic metastases, the location of the primary tumor, and different neoadjuvant therapies are of nonprognostic value.

From the *Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany; †Department of Radiology, Cairo University Hospital, Cairo; and ‡Department of Radiology, Alexandria University Hospital, Alexandria, Egypt.

Received for publication September 30, 2012; and accepted for publication, after revision, December 8, 2012.

Conflicts of interest and sources of funding: none declared.

Thomas Josef Vogl and Verena Freier equally contributed to the current study.

Reprints: Thomas Josef Vogl, MD, Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. E-mail:

© 2013 by Lippincott Williams & Wilkins