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Microwave ablation for colorectal cancer metastasis to the liver: a single-center retrospective analysis

Authors :
John F. Swietlik
Sam J. Lubner
Sharon M. Weber
Noelle K. LoConte
Daniel Mulkerin
Emily A. Knott
Daniel E. Abbott
J. Louis Hinshaw
Annie M. Zlevor
Marci L. Alexander
Colin Longhurst
Dustin A. Deming
Timothy J. Ziemlewicz
Paul F. Laeseke
Meghan G. Lubner
Fred T. Lee
Shane A. Wells
Allison B. Couillard
Nataliya Uboha
Source :
J Gastrointest Oncol
Publication Year :
2021
Publisher :
AME Publishing Company, 2021.

Abstract

BACKGROUND: The purpose of this study is to evaluate the safety and intermediate-term efficacy of percutaneous microwave (MW) ablation for the treatment of colorectal liver metastases (CRLM) at a single institution. METHODS: A retrospective review was performed of all CRLM treated with MW ablation from 3/2011 to 7/2020 (102 tumors; 72 procedures; 57 patients). Mean age was 60 years (range, 36–88) and mean tumor size was 1.8 cm (range, 0.5–5.0 cm). The patient population included 19 patients with extra-hepatic disease. Chemotherapy (pre- and/or post-ablation) was given in 98% of patients. Forty-five sessions were preceded by other focal CRLM treatments including resection, ablation, radiation, and radioembolization. Kaplan-Meier curves were used to estimate local tumor progression-free survival (LTPFS), disease-free survival (DFS), and overall survival (OS) and multivariate analysis (Cox Proportional Hazards model) was used to test predictors of OS. RESULTS: Technical success (complete ablation) was 100% and median follow-up was 42 months (range, 1–112). There was a 4% major complication rate and an overall complication rate of 8%. Local tumor progression (LTP) rate during the entire study period was 4/98 (4%), in which 2 were retreated with MW ablation for a secondary LTP-rate of 2%. LTP-free survival at 1, 3, and 5 years was 93%, 58%, and 39% and median LTP-free survival was 48 months. OS at 1, 3, and 5 years was 96%, 66%, 47% and median OS was 52 months. There were no statistically significant predictors of OS. CONCLUSIONS: MW ablation of hepatic colorectal liver metastases appears safe with excellent local tumor control and prolonged survival compared to historical controls in selected patients. Further comparative studies with other local treatment strategies appear indicated.

Details

ISSN :
2219679X and 20786891
Volume :
12
Database :
OpenAIRE
Journal :
Journal of Gastrointestinal Oncology
Accession number :
edsair.doi.dedup.....10b46b54251f0cd8ae0c9df99c5cc6f8