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MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts.
- Source :
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Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2016 Oct; Vol. 39 (10), pp. 1438-46. Date of Electronic Publication: 2016 Jul 07. - Publication Year :
- 2016
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Abstract
- Purpose: To retrospectively analyse the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) in the treatment of unresectable colorectal liver metastases (CRLM) in proximity to large vessels and/or major bile ducts.<br />Method and Materials: A database search was performed to include patients with unresectable histologically proven and/or (18)F-FDG-PET avid CRLM who were treated with RFA or MWA between January 2001 and September 2014 in a single centre. All lesions that were considered to have a peribiliary and/or perivascular location were included. Univariate logistic regression analysis was performed to assess the distribution of patient, tumour and procedure characteristics. Multivariate logistic regression was used to correct for potential confounders.<br />Results: Two hundred and forty-three patients with 774 unresectable CRLM were ablated. One hundred and twenty-two patients (78 males; 44 females) had at least one perivascular or peribiliary lesion (n = 199). Primary efficacy rate of RFA was superior to MWA after 3 and 12 months of follow-up (P = 0.010 and P = 0.022); however, after multivariate analysis this difference was non-significant at 12 months (P = 0.078) and vanished after repeat ablations (P = 0.39). More CTCAE grade III complications occurred after MWA versus RFA (18.8 vs. 7.9 %; P = 0.094); biliary complications were especially common after peribiliary MWA (P = 0.002).<br />Conclusion: For perivascular CRLM, RFA and MWA are both safe treatment options that appear equally effective. For peribiliary CRLM, MWA has a higher complication rate than RFA, with similar efficacy. Based on these results, it is advised to use RFA for lesions in the proximity of major bile ducts.<br />Competing Interests: Compliance with Ethical Standards Conflicts of interest On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent Informed consent was obtained from all individual participants included in the study.
- Subjects :
- Ablation Techniques methods
Adult
Aged
Aged, 80 and over
Bile Ducts pathology
Bile Ducts surgery
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Catheter Ablation methods
Colorectal Neoplasms pathology
Colorectal Neoplasms surgery
Liver Neoplasms secondary
Liver Neoplasms surgery
Microwaves therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-086X
- Volume :
- 39
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27387188
- Full Text :
- https://doi.org/10.1007/s00270-016-1413-3