Laparoscopic Versus Open Thermal Ablation of Colorectal Liver Metastases: A Propensity Score-Based Analysis of Local Control of the Ablated Tumors

Giglio, Mariano Cesare; Logghe, Bram; Garofalo, Eleonora; Tomassini, Federico; Vanlander, Aude; Berardi, Giammauro; Montalti, Roberto; Troisi, Roberto

doi:10.1245/s10434-020-08243-w

Cited by 8 publications

(5 citation statements)

References 42 publications

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“…A multicenter retrospective study including 473 microwave ablations reported no superiority of the surgical approach over TA over OS or DFS, but surgical TA resulted in lower local recurrence ( p = 0.014) without significantly increasing the complications rate [ 48 ]. Finally, a PSM study enrolling 168 patients investigated the effectiveness of the laparoscopic approach for TA, concluding that laparoscopic TA has the same efficacy as open surgical thermal ablations with less invasiveness [ 49 ]. However, laparoscopic TA is technically more challenging than percutaneous or open TA, owing to its different three-dimensional orientation, reduced freedom in needle angulation and orientation, and need to master intraoperative US.…”

Section: Current Evidence About the Management Of Multiple Hccmentioning

confidence: 99%

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Cassese

Han

Cho

et al. 2022

Cancers

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According to the Barcelona Clinic Liver Cancer (BCLC) staging system, the optimal strategy for patients with multiple HCC within the Milan Criteria is liver transplantation (LT). However, LT cannot be offered to all the patients due to organ shortages and long waiting lists, as well as because of the advanced disease carrying a high risk of poor outcomes. For early stages, liver resection (LR) or thermal ablation (TA) can be proposed, while trans-arterial chemoembolization (TACE) still remains the treatment of choice for intermediate stages (BCLC-B). Asian guidelines and the National Comprehensive Cancer Network suggest LR for resectable multinodular HCCs, even beyond Milan criteria. In this scenario, a growing body of evidence shows better outcomes after surgical resection when compared with TACE. Trans-arterial radioembolization (TARE) and stereotaxic body radiation therapy (SBRT) can also play an important role in this setting. Furthermore, the role of minimally invasive liver surgery (MILS) specifically for patients with multiple HCC is still not clear. This review aims to summarize current knowledge about the best therapeutical strategy for multiple HCC while focusing on the role of minimally invasive surgery and on the most attractive future perspectives.

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Section: Current Evidence About the Management Of Multiple Hccmentioning

confidence: 99%

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Cassese

Han

Cho

et al. 2022

Cancers

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“…LURFA has also been shown to reduce procedural morbidity and mortality compared to the open surgical approach (11)(12)(13). Nevertheless, laparoscopic resection of tumors in upper liver segments is associated with higher technical di culties (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Mid- to long-term outcome of laparoscopic ultrasound–guided radiofrequency ablation for malignant hepatic tumors

Chern,

Lin,

Lin

et al. 2024

Journal of Gastrointestinal Surgery

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“…Laparoscopic ablation is increasingly being performed due to its minimal invasive character compared to ablations via laparotomy, and local control rates are reported to be comparable between the two approaches. [ 11 ] However, laparoscopic ablation is technically more demanding and requires a fairly high level of expertise, which is presumably the reason that it is not yet widely embraced worldwide [ 4 , 12 , 13 ]. The percutaneous approach is mainly preferred in patients whose comorbid conditions preclude surgery, for centrally located tumors otherwise requiring a major resection (parenchyma-sparing), or in patients with regional or local tumor progression after prior local liver treatment [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…When it comes to analyzing the efficacy and improvement of a certain treatment modality, the technique to eradicate tumors can best be elucidated by analyzing local control and time-to-local tumor progression [ 2 , 27 ]. Local tumor progression (LTP) rates after thermal ablation of CRLM vary widely in the literature, ranging 7.6–22.2% for patients treated by percutaneous procedures and 2.7–9.5% for patients treated by open ablation [ 7 , 11 , 28 – 32 ]. Median overall survival (OS) rates after thermal ablation are reported mainly in matched cohorts or after multivariable analysis and vary from 34.3 to 53.2 months with 5- and 10-year survival rates of 20.8–60.0% and 18.0%, respectively [ 9 , 19 , 20 , 33 – 39 ] .…”

Section: Introductionmentioning

confidence: 99%

Improved Outcomes of Thermal Ablation for Colorectal Liver Metastases: A 10-Year Analysis from the Prospective Amsterdam CORE Registry (AmCORE)

Puijk

Dijkstra

Bemd

et al. 2022

Cardiovasc Intervent Radiol

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Background To analyze long-term oncological outcomes of open and percutaneous thermal ablation in the treatment of patients with colorectal liver metastases (CRLM). Methods This assessment from a prospective, longitudinal tumor registry included 329 patients who underwent 541 procedures for 1350 CRLM from January 2010 to February 2021. Three cohorts were formed: 2010–2013 (129 procedures [53 percutaneous]), 2014–2017 (206 procedures [121 percutaneous]) and 2018–2021 (206 procedures [135 percutaneous]). Local tumor progression-free survival (LTPFS) and overall survival (OS) data were estimated using the Kaplan–Meier method. Potential confounding factors were analyzed with uni- and multivariable Cox regression analyses. Results LTPFS improved significantly over time for percutaneous ablations (2-year LTPFS 37.7% vs. 69.0% vs. 86.3%, respectively, P < .0001), while LTPFS for open ablations remained reasonably stable (2-year LTPFS 87.1% [2010–2013], vs. 92.7% [2014–2017] vs. 90.2% [2018–2021], P = .12). In the latter cohort (2018–2021), the open approach was no longer superior regarding LTPFS (P = .125). No differences between the three cohorts were found regarding OS (P = .088), length of hospital stay (open approach, P = .065; percutaneous approach, P = .054), and rate and severity of complications (P = .404). The rate and severity of complications favored the percutaneous approach in all three cohorts (P = .002). Conclusion Over the last 10 years efficacy of percutaneous ablations has improved remarkably for the treatment of CRLM. Oncological outcomes seem to have reached results following open ablation. Given its minimal invasive character and shorter length of hospital stay, whenever feasible, percutaneous procedures may be favored over an open approach.

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Laparoscopic Versus Open Thermal Ablation of Colorectal Liver Metastases: A Propensity Score-Based Analysis of Local Control of the Ablated Tumors

Cited by 8 publications

References 42 publications

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Mid- to long-term outcome of laparoscopic ultrasound–guided radiofrequency ablation for malignant hepatic tumors

Improved Outcomes of Thermal Ablation for Colorectal Liver Metastases: A 10-Year Analysis from the Prospective Amsterdam CORE Registry (AmCORE)

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