CT-guided radiofrequency ablation in the treatment of recurrent rectal cancer.

Locally recurrent rectal adenocarcinoma remains a therapeutic challenge that is unsatisfactorily managed by surgery and radiation therapy or chemotherapy. Palliative CT-guided radiofrequency ablation was used in 14 patients with recurrent rectal adenocarcinoma who had been previously treated with abdominoperineal resection and radiation therapy. Follow-up CT or MRI was performed at 3, 6, 12, and 24 months. Pain palliation was monitored by the brief pain inventory (BPI). One month after radiofrequency ablation, 11 patients reported satisfactory BPI mean scores reduction compared to baseline (from 7.6 to 3.4 and from 5.1 to 1.6 for worst and average pain, respectively). In two unresponsive patients, retreatment was successfully performed at 3 months. After 24 months, worst and average pain scores further decreased (to 2.6 and 0.8, respectively) in 10 patients, who, at imaging, showed an ablation zone covering the entire original lesion in two patients and incomplete ablation in eight. In our experience, radiofrequency ablation is a safe and effective palliative treatment for patients with recurrent rectal adenocarcinoma.