A Single-Center Retrospective Analysis of Periprocedural Variables Affecting Local Tumor Progression after Radiofrequency Ablation of Colorectal Cancer Liver Metastases

Han, Kichang; Kim, Jin Hyoung; Yang, Seul Gi; Park, Seong Ho; Choi, Ho Jin; Chun, Seng-Yong; Kim, Pyo Nyun; Park, Jihong; Lee, Myeongjee

doi:10.1148/radiol.2020200109

Cited by 56 publications

(66 citation statements)

References 29 publications

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“…Although studies previously displayed that LTP may be attributed to the growth of microscopic viable tumor at the site of ablation and pointed to the potential effect of ablation margin on LTP [14,42,43], the influence of ablation margin on new metastases need to be continually explored. In addition, more previous studies showed that ablation margins greater than 5 mm are essential for satisfactory local tumor control [14,[16][17][18]22,23]. While there was an ablation zone with a minimal margin uniformly larger than 5 mm in the current study cohort, so there may need a longer follow-up time to determine the outcome difference between subgroups.…”

Section: Discussionmentioning

confidence: 70%

“…And the relevant reports analyzed the factors affecting oncological outcomes after RFA of CRLM, such as RAS gene, ablation margin and modified clinical risk score (CRS), embryonic origin of the primary lesion, etc. [14][15][16][17][18][19][20][21][22][23][24][25]. Moreover, the previous studies also documented the favorable local control and long-term survival benefit for CRLM patients receiving RFA in addition to systemic chemotherapy [26][27][28].…”

Section: Introductionmentioning

confidence: 86%

See 1 more Smart Citation

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation

Liu

Zhang

et al. 2021

International Journal of Hyperthermia

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 86%

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation

Liu

Zhang

et al. 2021

International Journal of Hyperthermia

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“…To the best of our knowledge, there are conflicting results in multiple studies on the safety and efficacy of RFA for subcapsular tumors. Recently, Han et al showed that subcapsular tumor location was an important independent risk factor (hazard ratio [HR], 1.9; 95% confidence interval [CI]: 1.1−3.1) for local tumor progression-free survival (LTPFS) of CLMs (10). Previous studies have also reported similar results (6,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 83%

Comparison of Percutaneous Radiofrequency Ablation for Subcapsular and Non-Subcapsular Colorectal Cancer Liver Metastases

Fan

Wang

et al. 2021

Front. Oncol.

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PurposeTo evaluate the efficacy and safety of percutaneous radiofrequency ablation (RFA) for subcapsular colorectal cancer liver metastases (CLMs).Materials and MethodsWith the approval of the Institutional Review Board, the clinical data of CLM patients who underwent percutaneous RFA for the first time from August 2010 to August 2020 were continuously collected. All CLMs were divided into subcapsular and non-capsular groups. Baseline characteristic data, technical effectiveness, minimal ablative margin, complications, local tumor progression (LTP), and overall survival (OS) between the two groups were analyzed using the t-test or chi-square test. A Cox regression model was used to evaluate the prognostic factors of LTP.ResultsOne hundred and ninety-nine patients (124 males; mean age, 60.2 years) with 402 CLMs (221 subcapsular; mean size, 16.0 mm) were enrolled in the study. Technical effectiveness was achieved in 93.5% (376/402) of CLMs, with a major complication rate of 5.5%. Compared with non-subcapsular tumors, the minimal ablative margin achieved in subcapsular CLM was smaller (χ2 = -8.047, P < 0.001). With a median follow-up time of 23 months (range, 3−96 months), 37.1% of the tumors had LTP. The estimated cumulative OS at 1, 3, and 5 years was 96.1%, 66.0%, and 44.2%, respectively. There were no statistically significant differences between the two groups in terms of technical effectiveness (χ2 = 0.484, P = 0.487), major complications (χ2 = 0.082, P = 0.775), local tumor progression-free survival (LTPFS) (χ2 = 0.881, P = 0.348), and OS (χ2 = 2.874, P = 0.090). Minimal ablative margin, tumor size (≥20 mm), and technical effectiveness were predictors of LTP (all P < 0.05).ConclusionRFA is a safe and effective technique for local tumor control of subcapsular CLMs.

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“…Immediate assessment of margins with an intraprocedural contrast agent-enhanced CT scan and the performance of additional ablation, if necessary, has been shown to result in excellent local tumor control rates. Han et al evaluated 365 CRC patients with 512 CLMs who underwent CT-guided RFA and immediate re-ablation in cases in which intra-procedural contrast agent-enhanced CT scan depicted tumor remnants; the authors reported 98% technical effectiveness at 92%, 41%, 30%, and 28% for 1-, 5-, 10-, and 15-year overall survival rates, respectively [ 30 ]. Shady at al.…”

Section: Imaging For Diagnosis and Guidancementioning

confidence: 99%

“…This is because the current evidence for stereotactic body radiotherapy (SBRT) in the management of colorectal cancer liver metastatic disease is sparse [57]. Numerous ablation papers in the literature report 3-year survival rates up to 88.6%, 5-year survival rates up to 53%, whilst longer survival rates at 7-10 years range from 18.0 to 35.9%; these rates are significantly higher than those reported after SBRT [2,29,[30][31][32][33][34]46,56]. Percutaneous ablation destructs the target tumor with a safety margin of normal parenchyma sparing the uninvolved hepatic tissue.…”

Section: Comparing Percutaneous Ablation To Other Therapiesmentioning

confidence: 99%

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

et al. 2021

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Approximately 50% of colorectal cancer patients will develop metastases during the course of the disease. Local or locoregional therapies for the treatment of liver metastases are used in the management of oligometastatic colorectal liver disease, especially in nonsurgical candidates. Thermal ablation (TA) is recommended in the treatment of limited liver metastases as free-standing therapy or in combination with surgery as long as all visible disease can be eradicated. Percutaneous TA has been proven as a safe and efficacious therapy offering sustained local tumor control and improved patient survival. Continuous technological advances in diagnostic imaging and guidance tools, the evolution of devices allowing for optimization of ablation parameters, as well as the ability to perform margin assessment have improved the efficacy of ablation. This allows resectable small volume diseases to be cured with percutaneous ablation. The ongoing detailed information and increasing understanding of tumor biology, genetics, and tissue biomarkers that impact oncologic outcomes as well as their implications on the results of ablation have further allowed for treatment customization and improved oncologic outcomes even in those with more aggressive tumor biology. The purpose of this review is to present the most common indications for image-guided percutaneous ablation in colorectal cancer liver metastases, to describe technical considerations, and to discuss relevant peer-reviewed evidence on this topic. The growing role of imaging and image-guidance as well as controversies regarding several devices are addressed.

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A Single-Center Retrospective Analysis of Periprocedural Variables Affecting Local Tumor Progression after Radiofrequency Ablation of Colorectal Cancer Liver Metastases

Cited by 56 publications

References 29 publications

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation

Comparison of Percutaneous Radiofrequency Ablation for Subcapsular and Non-Subcapsular Colorectal Cancer Liver Metastases

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

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