Prognostic value of carcinoembryonic antigen level in patients with colorectal cancer liver metastasis treated with percutaneous microwave ablation under ultrasound guidance

Peng, Shaoyong; Huang, Pinzhu; Yu, Huichuan; Wen, Yafei; Luo, Yanxin; Xiao-lin, Wang; Zhou, Jiaming; Qin, Si; Li, Tuoyang; Chen, Yao; Liu, Guangjian; Huang, Meijin

doi:10.1097/md.0000000000010044

Cited by 15 publications

(8 citation statements)

References 43 publications

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“…This retrospective comparative study was approved by our ethical committee. The covariates were selected based on clinical relevance and the results of previous studies (18)(19)(20)(21). Standardized terminology and reporting criteria (22) were used for the comparison of treatment outcomes between the two groups.…”

Section: Methodsmentioning

confidence: 99%

Percutaneous Microwave Ablation Versus Open Surgical Resection for Colorectal Cancer Liver Metastasis

Zhao¹,

Cheng²,

Han³

et al. 2021

Front. Oncol.

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PurposeTo compare the therapeutic outcomes between open surgical resection (OSR) and percutaneous microwave ablation (PMWA) for colorectal liver metastasis (CRLM) ≤3 cm.MethodsIn this retrospective study, 200 consecutive patients with 306 CRLMs were reviewed. Overall survival (OS), disease-free survival (DFS), local tumour progression (LTP), intrahepatic distant recurrence, and extrahepatic metastasis were analysed to compare the therapeutic efficacy. Cox proportional hazards regression analysis was used to identify the prognostic factors for OS and DFS. Major complications and postoperative hospital stay were also assessed.ResultThe 1-, 3-, and 5-year OS rates were 91.6%, 64.1%, and 46.3%, respectively, in the PMWA group and 89.7%, 62.4% and 44.7%, respectively, in the OSR group (P=0.839). The 1-, 3-, and 5-year DFS rates were 61.9%, 44.8%, and 41.3%, respectively, in the PMWA group and 58.1%, 24.4%, and 18.3%, respectively, in the OSR group (P =0.066). The two groups had comparable 5-year cumulative rates of intrahepatic distant recurrence (P=0.627) and extrahepatic metastasis (P=0.884). The 5-year cumulative LTP rate was lower in the OSR group than in the PMWA group (P=0.023). The rate of major complications was higher in the OSR group than in the PMWA group (P =0.025), and the length of hospital stay after treatment was shorter in the PMWA group (P<0.001).ConclusionThere were no significant differences in OS or DFS between the two groups. PMWA was associated with increased LTP, fewer postoperative days and fewer major complications.

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Section: Methodsmentioning

confidence: 99%

Percutaneous Microwave Ablation Versus Open Surgical Resection for Colorectal Cancer Liver Metastasis

Zhao¹,

Cheng²,

Han³

et al. 2021

Front. Oncol.

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“…A regression model of factors influencing ASR within 1 year was created (baseline model A), including factors previously described to be associated with ASR, as assessed in a meticulous literature search (13)(14)(15)(16)(17)(18)(19)(20)(21)(22). To assess the optimal application of 3D-QAM and its influence on ASR, 3D-QAM was then added in varying outputs to the baseline model as follows: i) Model B: All clinical factors of model A plus 3D-QAM as a continuous variable of the minimal ablation margin (MAM) (33); ii) Model C: All clinical factors of model A plus 3D-QAM as the optimal discrimination threshold of all possible 3D-QAM distributions, as identified in receiver operating characteristic (ROC) curves; and iii) Model D: All clinical factors of model A plus 3D-QAM as the optimal discrimination threshold of the previously described 5-mm margin (34).…”

Section: Quantitative Ablation Margin and Ablation Site Recurrencementioning

confidence: 99%

“…The main remaining drawback of thermal ablation is the relatively frequent suspicion of viable tumor tissue at the edge of the ablation zone [ablation site recurrence (ASR)] reported between 2% and 41% for colorectal liver metastases (CRLM) (8,9). Several factors negatively correlated with ASR after thermal ablation of CRLM have been identified in multivariable models, including tumor size (10)(11)(12)(13)(14)(15), prior liver resection (16), carcinoembryonic antigen (CEA) levels (17), proximity to larger intrahepatic vessels (10,13,18), and mutational status of KRAS oncogenes (16,(19)(20)(21). Most importantly, the completeness of ablation as described by the extent of the ablation margin represents an independent predictor of ASR (16,18,19,22,23).…”

Section: Introductionmentioning

confidence: 99%

3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

et al. 2021

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BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM <1 mm for >23% of the tumor surface, ii) 3D-QAM <5 mm for >45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as >23% <1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.

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“…that confounding factors between the ablation group and the hepatectomy group, such as the number or size of CRLM, RAS status, ki-67, clinical risk score (CRS), CEA and extrahepatic diseases, can affect the results [16,34,37,[45][46][47][48][49][50][51][52][53][54][55].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome for colorectal liver metastases: combining hepatectomy with intraoperative ultrasound guided open microwave ablation versus hepatectomy alone

Dai

Yuan

et al. 2021

International Journal of Hyperthermia

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Objective: To compare the long-term outcome of combining hepatectomy with intraoperative ultrasound (IOUS)-guided open microwave ablation (MWA) versus hepatectomy alone in patients with colorectal cancer liver metastases (CRLM). Method: A retrospective analysis of patients with CRLM who underwent hepatectomy alone (HT group; 380 patients) or hepatectomy combined with IOUS-guided open MWA (HT þ MWA group; 57 patients) from April 2002 to September 2018 was conducted at our center. A propensity scorematched (PSM) analysis was used to reduce data bias between the two groups. Results: The overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups after matching. Although intrahepatic recurrence was more frequent in the HT þ MWA group in both the whole and matched cohort, the two groups exhibited similar rates of extrahepatic recurrence as well as concomitant intra-and extrahepatic recurrence. A higher number of CRLM (>3), larger maximum-size and absence of response to induction chemotherapy were independent risk factors for OS. Conclusion: The oncological outcomes of hepatectomy combined with intraoperative open ablation was not significantly different to hepatectomy alone and should be considered as a safe and fair option for patients with difficultly resectable CRLM.

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Prognostic value of carcinoembryonic antigen level in patients with colorectal cancer liver metastasis treated with percutaneous microwave ablation under ultrasound guidance

Cited by 15 publications

References 43 publications

Percutaneous Microwave Ablation Versus Open Surgical Resection for Colorectal Cancer Liver Metastasis

Percutaneous Microwave Ablation Versus Open Surgical Resection for Colorectal Cancer Liver Metastasis

3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

Long-term outcome for colorectal liver metastases: combining hepatectomy with intraoperative ultrasound guided open microwave ablation versus hepatectomy alone

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