scholarly journals Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

2015 ◽  
Vol 25 (12) ◽  
pp. 3438-3454 ◽  
Author(s):  
Alice Gillams ◽  
Nahum Goldberg ◽  
Muneeb Ahmed ◽  
Reto Bale ◽  
David Breen ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Thermal Ablation ◽  
Colorectal Liver Metastases ◽  
Interventional Oncology ◽  
Position Paper ◽  
International Panel

Altered growth patterns of colorectal liver metastases after thermal ablation

Surgery ◽  
2006 ◽  
Vol 139 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Mehrdad Nikfarjam ◽  
Vigayaragavan Muralidharan ◽  
Christopher Christophi
Keyword(s):  
Liver Metastases ◽  
Thermal Ablation ◽  
Colorectal Liver Metastases ◽  
Growth Patterns

scholarly journals Thermal Ablation of Metastatic Colon Cancer to the Liver

2019 ◽  
Vol 36 (04) ◽  
pp. 310-318 ◽  
Author(s):  
Juan C. Camacho ◽  
Elena N. Petre ◽  
Constantinos T. Sofocleous
Keyword(s):  
Liver Metastases ◽  
Thermal Ablation ◽  
Interventional Oncology ◽  
Percutaneous Ablation ◽  
Western World ◽  
Metastatic Colon Cancer ◽  
Term Survival ◽  
Ablative Therapies

AbstractColorectal cancer (CRC) is responsible for approximately 10% of cancer-related deaths in the Western world. Liver metastases are frequently seen at the time of diagnosis and throughout the course of the disease. Surgical resection is often considered as it provides long-term survival; however, few patients are candidates for resection. Percutaneous ablative therapies are also used in the management of this patient population. Different thermal ablation (TA) technologies are available including radiofrequency ablation, microwave ablation (MWA), laser, and cryoablation. There is growing evidence about the role of interventional oncology and image-guided percutaneous ablation in the management of metastatic colorectal liver disease. This article aims to outline the technical considerations, outcomes, and rational of TA in the management of patients with CRC liver metastases, focusing on the emerging role of MWA.

Immediate post-thermal ablation biopsy of colorectal liver metastases to predict oncologic outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4602-4602
Author(s):  
Nikiforos Vasiniotis Kamarinos ◽  
Efsevia Vakiani ◽  
Mithat Gonen ◽  
Nancy E. Kemeny ◽  
Anne M. Covey ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Tumor Cells ◽  
Tumor Size ◽  
Thermal Ablation ◽  
Colorectal Liver Metastases ◽  
Univariate Analysis ◽  
Contrast Material ◽  
Maximum Diameter ◽  
Minimal Risk ◽  
Viable Tumor

4602 Background: Thermal ablation (TA) is used as a local cure for selected colorectal liver metastases (CLM) with minimal risk. A critical limitation of TA has been early local tumor progression (LTP). The goal of this study is to establish the role of ablation zone (AZ) biopsy in predicting LTP. Methods: This institutional review board-approved prospective study included patients with CLM of 5cm or less in maximum diameter, with confined liver disease or stable, limited extrahepatic disease. Both radiofrequency(RF) and microwave(MW) ablation modalities were used. A biopsy of the center and margin of the AZ was performed immediately after ablation. The applicators were also examined for the presence of viable tumor cells. All samples containing morphologically identified tumor cells were further interrogated with immunohistochemistry to determine the proliferative and viability potential of the detected tumor cells. Ablation margin size was evaluated on the first CT scan performed 4–8 weeks after ablation and was confirmed by 3D assessment with Ablation Confirmation Software (Neuwave™). Variables were evaluated as predictors of time to LTP with the competing-risks model (uni- and multivariate analyses). Results: Between November 2009 and February 2019, 102 patients with 182 CLMs were enrolled. Mean tumor size was 2.0 cm (range, 0.6–4.8 cm). MW was used in 95/182 (52%) tumors and RF in 87/182 (48%). Median follow-up was 19 months. Technical effectiveness was evident in 178/182 (97%) ablated tumors on the first contrast material–enhanced CT at 4–8-weeks post-ablation. The cumulative incidence of LTP at 12 months was 19% (95% confidence interval [CI]: 14, 27). Samples from 64 (35%) of the 178 technically successful cases contained viable tumor. At univariate analysis, tumor size, minimal margin size, and biopsy results were significant in predicting LTP. In a multivariate model, margin size of less than 5 mm (P < .001; hazard ratio [HR], 4.3), and positive biopsy results (P = .02; HR, 1.8) remained significant. LTP within 12 months after TA was noted in 3% (95% CI: 1, 6) of tumor-negative biopsy CLMs with margins of at least 5 mm. Conclusions: Biopsy and pathologic examination of the AZ predicts LTP regardless of TA modality used. This can optimize ablation as a potential local cure for patients with limited CLM.

scholarly journals Systematic review of thermal ablation techniques for resectable colorectal liver metastases

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S268
Author(s):  
M. Di Martino ◽  
G. Rompianesi ◽  
I. Mora-Guzmán ◽  
E Martín Pérez ◽  
R. Montalti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Metastases ◽  
Thermal Ablation ◽  
Colorectal Liver Metastases ◽  
Ablation Techniques

scholarly journals Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2769
Author(s):  
Madelon Dijkstra ◽  
Sanne Nieuwenhuizen ◽  
Robbert S. Puijk ◽  
Florentine E.F. Timmer ◽  
Bart Geboers ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Hospital Stay ◽  
Partial Hepatectomy ◽  
Thermal Ablation ◽  
Colorectal Liver Metastases ◽  
Local Treatment ◽  
Length Of Hospital Stay ◽  
Progression Free Survival ◽  
Free Survival ◽  
Subgroup Analyses

The aim of this study was to assess safety, efficacy and survival outcomes of repeat thermal ablation as compared to repeat partial hepatectomy in patients with recurrent colorectal liver metastases (CRLM). This Amsterdam Colorectal Liver Met Registry (AmCORE) based study of two cohorts, repeat thermal ablation versus repeat partial hepatectomy, analyzed 136 patients (100 thermal ablation, 36 partial hepatectomy) and 224 tumors (170 thermal ablation, 54 partial hepatectomy) with recurrent CRLM from May 2002 to December 2020. The primary and secondary endpoints were overall survival (OS), distant progression-free survival (DPFS) and local tumor progression-free survival (LTPFS), estimated using the Kaplan–Meier method, and complications, analyzed using the chi-square test. Multivariable analyses based on Cox proportional hazards model were used to account for potential confounders. In addition, subgroup analyses according to patient, initial and repeat local treatment characteristics were performed. In the crude overall comparison, OS of patients treated with repeat partial hepatectomy was not statistically different from repeat thermal ablation (p = 0.927). Further quantification of OS, after accounting for potential confounders, demonstrated concordant results for repeat local treatment (hazard ratio (HR), 0.986; 95% confidence interval (CI), 0.517–1.881; p = 0.966). The 1-, 3- and 5-year OS were 98.9%, 62.6% and 42.3% respectively for the thermal ablation group and 93.8%, 74.5% and 49.3% for the repeat resection group. No differences in DPFS (p = 0.942), LTPFS (p = 0.397) and complication rate (p = 0.063) were found. Mean length of hospital stay was 2.1 days in the repeat thermal ablation group and 4.8 days in the repeat partial hepatectomy group (p = 0.009). Subgroup analyses identified no heterogeneous treatment effects according to patient, initial and repeat local treatment characteristics. Repeat partial hepatectomy was not statistically different from repeat thermal ablation with regard to OS, DPFS, LTPFS and complications, whereas length of hospital stay favored repeat thermal ablation. Thermal ablation should be considered a valid and potentially less invasive alternative for small-size (0–3 cm) CRLM in the treatment of recurrent new CRLM. While, the eagerly awaited results of the phase III prospective randomized controlled COLLISION trial (NCT03088150) should provide definitive answers regarding surgery versus thermal ablation for CRLM.

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