Surgical microwave ablation of otherwise non-resectable colorectal cancer liver metastases: Expanding opportunities for long term survival

McEachron, Kendall R.; Ankeny, Jacob S.; Robbins, Alexandria J.; Altman, Ariella M.; Marmor, Schelomo; D’Souza, Donna; Schat, Robben; Spilseth, Benjamin; Jensen, Eric H.

doi:10.1016/j.suronc.2020.11.016

Cited by 11 publications

(16 citation statements)

References 14 publications

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“…The general characteristics of these twelve papers are shown in Table 2 , Table 3 , Table 4 and Table 5 [ 20 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Eight studies (66.7%) were retrospective [ 29 , 30 , 32 , 34 , 36 , 37 , 38 , 39 ], and a total of 395 patients with CRLM were treated with MWA, 257 of whom were male (65%). The mean patients’ age was 58.9 ± 9 years.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported data concerning MWA conducted through a surgical approach [ 20 , 29 , 30 , 32 , 35 , 37 , 38 , 39 ] ( Table 8 and Table 9 ). In this group of analyses, 602 lesions were treated in 287 patients, and the mean diameter of the lesions was 15.51 mm (±7.16 mm).…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, for oncological reasons and due to the patients’ condition, few patients are candidates for curative-intent surgery. In this setting, when percutaneous thermal ablation techniques have been used in non-selected patients, oncological data from thermal ablation seemed to not be optimal when compared with a curative-intent surgical approach [ 32 ]. Modern CHT and target therapies for CRLM increased not only the resection rates but also the number of patients with complex CRLM and a high risk of recurrence in patients [ 32 , 40 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this setting, when percutaneous thermal ablation techniques have been used in non-selected patients, oncological data from thermal ablation seemed to not be optimal when compared with a curative-intent surgical approach [ 32 ]. Modern CHT and target therapies for CRLM increased not only the resection rates but also the number of patients with complex CRLM and a high risk of recurrence in patients [ 32 , 40 , 42 ]. The main challenge is to define which patients can benefit most from surgery and thermal ablation techniques without increasing the morbidity and mortality rates [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

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Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Mimmo

Pegoraro

Rhaiem

et al. 2022

Cancers

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(1) Background: colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancer; however, few patients are fit for curative surgery. Microwave ablation (MWA) showed promising outcomes in this cohort of patients. This systematic review and pooled analysis aimed to analyze the oncological results of MWA for CRLM. (2) Methods: Following PRISMA guidelines, PubMed, Scopus, EMBASE, Google Scholar, Science Direct, and the Wiley Online Library databases were searched for reports published before January 2021. We included papers assessing MWA, treating resectable CRLM with curative intention. We evaluated the reported MWA-related complications and oncological outcomes as being recurrence-free (RF), free from local recurrence (FFLR), and overall survival rates (OS). (3) Results: Twelve out of 4822 papers (395 patients) were finally included. Global RF rates at 1, 3, and 5 years were 65.1%, 44.6%, and 34.3%, respectively. Global FFLR rates at 3, 6, and 12 months were 96.3%, 89.6%, and 83.7%, respectively. Global OS at 1, 3, and 5 years were 86.7%, 59.6%, and 44.8%, respectively. A better FFLR was reached using the MWA surgical approach at 3, 6, and 12 months, with reported rates of 97.1%, 92.7%, and 88.6%, respectively. (4) Conclusions: Surgical MWA treatment for CRLM smaller than 3 cm is a safe and valid option. This approach can be safely included for selected patients in the curative intent approaches to treating CRLM.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Mimmo

Pegoraro

Rhaiem

et al. 2022

Cancers

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show abstract

“…All patients were treated by a single surgeon with a Certus 140 2.45 GHz ablation system (Neuwave Medical, Madison, WI, USA) with laparoscopic ultrasound (BK Medical, Peabody, MA, USA) as previously reported by our group (10). Within 2 weeks of surgery, all patients had repeat MRI to assess for primary treatment failure (incomplete ablation) or missed lesions.…”

Section: Methodsmentioning

confidence: 99%

Surgical microwave ablation for multifocal non-resectable liver metastases: a single institution experience treating five or more liver lesions

Wothe¹,

McEachron²,

Marmor³

et al. 2021

J Gastrointest Oncol

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Recurrence patterns after complex multimodality therapy and hepatic arterial infusion for colorectal liver metastases: A reflection of biology and technique

Hernandez,

Fan,

Sandhu

et al. 2024

Journal of Surgical Oncology

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Background and MethodsWe characterized colorectal liver metastasis recurrence and survival patterns after surgical resection and intraoperative ablation ± hepatic arterial infusion pump (HAIP) placement. We estimated patterns of recurrence and survival in patients undergoing contemporary multimodal treatments. Between 2017 and 2021, patient, tumor characteristics, and recurrence data were collected. Primary outcomes included recurrence patterns and survival data based on operative intervention.ResultsThere were 184 patients who underwent hepatectomy and intraoperative ablation. Sixty patients (32.6%) underwent HAIP placement. A total of 513 metastases were ablated, median total of 2 ablations per patient. Median time to recurrence was 31 [22–40] months. Recurrence patterns included tumor at ablative margin on first scheduled postoperative imaging (8, 4.3%), local tumor recurrence at ablative site (69, 37.5%), and non‐ablated liver tumor recurrence (38, 20.6%). In patients who underwent HAIP placement, the rate of liver recurrence was reduced (45% vs 70.9%, p = 0.0001). Median overall survival was 64 [41‐58] months and prolonged survival was associated with HAIP treatment (85 [66–109] vs 60 [51–70] months.Conclusions and DiscussionHepatic recurrence is common and combination of intraoperative ablation and HAIP treatments were associated with prolonged survival. These data may reflect patient selection however, future work will clarify preoperative tumor and patient characteristics that may better predict recurrence expectations.

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Surgical microwave ablation of otherwise non-resectable colorectal cancer liver metastases: Expanding opportunities for long term survival

Cited by 11 publications

References 14 publications

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Surgical microwave ablation for multifocal non-resectable liver metastases: a single institution experience treating five or more liver lesions

Recurrence patterns after complex multimodality therapy and hepatic arterial infusion for colorectal liver metastases: A reflection of biology and technique

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