Radiofrequency ablation of colorectal splenic metastasis.

The radiofrequency ablation treatment of secondary tumors, particularly in the liver, is gaining most of the attention in the field because it may obviate major surgery [1]. It is now established that surgical resection of the liver in patients with colorectal cancer may be curative, with survival rates of 25-40% at 5-year follow-up and an overall median survival of 33 months [2]. The need for an alternative treatment stems mainly from the facts that only 20% of colorectal cancer patients are suitable for metastasectomy and that the surgery is associated with considerable perioperative morbidity as well as a mortality rate of 2-10% [2]. Moreover, tumor in the liver recurs in 53-68% of patients, and a repeated resection can be performed in only a minority of such patients. Studies [1,2,3,4] have found that radiofrequency tumor ablation, when compared with surgical resection, entails less invasiveness, markedly reduced treatment costs, and lower morbidity and mortality rates. In addition, radiofrequency tumor ablation allows treatment of nonsurgical candidates and the option of repeating the minimally invasive treatment in the event of local recurrence or new metastases. However, none of these studies involved the spleen (most likely because of the reluctance to insert a large-bore needle into a highly vascularized organ). We here report our experience in performing radiofrequency ablation of tumors in the spleen. Our aim was to verify the feasibility of coagulative necrosis in a colorectal splenic metastasis, this being a very vascularized lesion in a highly vascularized tissue.