Percutaneous radiofrequency ablation of solitary hepatic metastases from colorectal cancer: risk factors of local tumor progression-free survival and overall survival

Lee, Hyun Jae; Lee, Min Woo; Ahn, Soo Hyun; Ik, Dong; Ko, Seong Eun; Kang, Tae Wook; Song, Kyoung Doo; Rhim, Hyunchul

doi:10.14366/usg.21256

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…For CLM, it has been shown that minimum ablation margins of at least 5 mm and ideally 10 mm are critical for prolonged local tumour progression-free survival, regardless of the thermal ablation modality used (RFA or MWA). 5,[12][13][14][15]17,18,[55][56][57][58] This is referred to as an A0 ablation, analogous to surgical resections with clear microscopic margins (R0) and is essential to provide local cure and serve as a surgical alternative, since the majority of intrahepatic micrometastases are within 1 cm of the gross tumour. 59 When a 10 mm minimal margin can be achieved, local tumour progression free-survival exceeds 95% and can offer a chance for local cure similar to surgery, without the associated morbidity.…”

Section: Ablation Marginsmentioning

confidence: 99%

“…Multiple studies have proven that the most important technical factor for local tumour control is ablation with adequate margins. For CLM, it has been shown that minimum ablation margins of at least 5 mm and ideally 10 mm are critical for prolonged local tumour progression‐free survival, regardless of the thermal ablation modality used (RFA or MWA) 5,12–15,17,18,55–58 . This is referred to as an A0 ablation , analogous to surgical resections with clear microscopic margins (R0) and is essential to provide local cure and serve as a surgical alternative, since the majority of intrahepatic micrometastases are within 1 cm of the gross tumour 59 .…”

Section: Ablation Marginsmentioning

confidence: 99%

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Percutaneous image‐guided ablation for hepatic metastases

Sotirchos,

Petre,

Sofocleous

2023

J Med Imag Rad Onc

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SummaryThe presence of hepatic metastases indicates advanced disease and is associated with significant morbidity and mortality, especially when the hepatic disease is not amenable to locoregional treatments. The primary tumour of origin, the distribution and extent of metastatic disease, the underlying liver reserve, the patient performance status and the presence of comorbidities are factors that determine whether a patient will benefit from hepatectomy or local curative‐intent treatments. For patients with metastatic colorectal cancer, the most common primary cancer that spreads to the liver, several studies have demonstrated a survival benefit for patients who can be treated with hepatectomy and/or percutaneous ablation, compared to those treated with chemotherapy alone. Despite advances in surgical techniques increasing the percentage of patients eligible for surgery, most patients have unresectable disease or are poor surgical candidates. Percutaneous ablation can be used to provide local disease control and prolong survival for both surgical and non‐surgical candidates. This is typically offered to patients with small hepatic metastases that can be ablated with optimal (≥10 mm) or at least adequate minimum ablation margins (≥5 mm), as high local tumour control rates can be achieved for these patients which are comparable to surgical resection. This review summarizes available evidence and outcomes following percutaneous ablation of the most frequently encountered types of hepatic metastases in the clinical practice of interventional oncology. Patient selection, technical considerations, follow‐up protocols and oncologic outcomes are presented and discussed.

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