Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years’ experience

Zhou, Fubo; Yu, Xiaoling; Liang, Ping; Han, Zhiyu; Cheng, Zhigang; Yu, Jie; Liu, Fangyi; Hu, Yi

doi:10.18632/oncotarget.18764

Cited by 21 publications

(16 citation statements)

References 46 publications

(53 reference statements)

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“…However, in this study we have also shown that there is evidence that PTL also has prognostic impact in patients with unresectable disease from the outset. For example, Zhou et al[ 27 ] reported on outcomes in 295 patients with unresectable CRCLM undergoing palliative radio-frequency ablation, and found similar rates of OS, but that the PFS was significantly better in patients with l -CRCLM (HR: 0.67, P = 0.012). Gu et al[ 28 ] also reported outcomes following palliative-intent radio-frequency ablation in patients with CRCLM, finding that patients with l -CRCLM had a significantly lower risk of recurrence outside of the ablation zone, with increased OS of 40.3 mo compared with 29.4 mo in r -CRCLM( P = 0.042).…”

Section: Discussionmentioning

confidence: 99%

Impact of primary tumour location on colorectal liver metastases: A systematic review

Bingham¹,

Shetye²,

Suresh³

et al. 2020

WJCO

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BACKGROUND Colorectal cancer (CRC) is the third most common cause of cancer-related death worldwide. Despite significant advances in screening, surgical management and adjuvant therapies, average 5-year survival seldom exceeds 60% in most developed nations. Metastatic disease represents the primary cause of mortality in patients with CRC, and the liver is the most common location for distant tumour spread. Up to 25% of patients are found to have synchronous liver metastases at the time of diagnosis and a further 30%-40% will develop metachronous disease in the course of follow-up. It has been suggested that primary tumour location [right side versus left side, primary tumour location (PTL)] can influence oncological outcomes in this patient group and that this should be considered in prognostic models and therapeutic decision-making algorithms. This suggestion is not universally accepted and there have been conflicting reports in the literature to date. AIM To provide a comprehensive summary of the available evidence regarding the impact of PTL on oncological outcomes in patients with colorectal cancer liver metastases (CRCLM). METHODS MEDLINE, EMBASE and COCHRANE were searched for relevant publications using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Data on oncological outcomes was then extracted from full text articles that met the predefined inclusion criteria. RESULTS A total of 41 studies were identified that met predefined inclusion criteria for this review. In 21 out of 38 studies that provided data on overall survival, a statistically significant improvement in overall survival was reported in patients with left sided primary tumours. These studies included a total of 13897 patients compared with 4306 patients in the studies that did not show a significant difference. Eight studies noted a similar trend towards improved disease-free or progression-free survival. Several authors observed distinct patterns of relapse after treatment of hepatic metastases according to PTL; for example hepatic recurrence after treatment of CRCLM appears to occur more aggressively with right-sided CRC. CONCLUSION Taken together, the findings of the present review indicate that PTL may have a role as an independent prognostic factor when determining treatment and disease surveillance strategies in CRC. The mechanisms responsible for this variation remain poorly understood, but are likely to relate to molecular, histological and embryological differences, as well as inherent differences in therapeutic sensitivity.

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Section: Discussionmentioning

confidence: 99%

Impact of primary tumour location on colorectal liver metastases: A systematic review

Bingham¹,

Shetye²,

Suresh³

et al. 2020

WJCO

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“…[ [23][24][25] In CRLM patients after microwave ablation, comparable outcomes were also observed between right-sided group and left-sided group. [26,27] In our study, significant worse RFS was found in right-sided group patients even when the comparison groups are balanced with respect to potential prognostic factors. Further analysis in patients before and after PSM also revealed that primary location of CRC was a prognostic factor for RFS.…”

Section: Prognostic Factors For Patients After Resection Of Liver Metmentioning

confidence: 41%

Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matched analysis

Yuan

Wang

Yuan

et al. 2020

Preprint

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Background Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score analysis (PSM). Results Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM ( P = 0.575; P = 0.453). However, significant different recurrence free survival (RFS) rate was found before and after PSM between right-sided and left-sided group ( P = 0.028, P = 0.003). Conclusions Primary tumor location of CRC impacts RFS for patients with liver metastases after resection. A more frequent follow up to detect early recurrence might be justified for CRLM patients with a right-sided CRC.

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“…24 Longer progression-free survival (PFS) has been observed in patients with leftsided colon cancer than those with right-sided colon cancer (median PFS: 17 vs. 13 months). 47 Notably, the results of thermal ablation seem to be similar to those of surgical resection. However, since image-guided thermal ablations are mainly applied for unresectable CRLMs, comparison between these techniques and surgical resection is complex, as existing retrospective series necessarily introduce selection biases when considering surgical versus nonsurgical candidates.…”

Section: Results Of Image-guided Thermal Ablation In Crlmsmentioning

confidence: 74%

Thermal Ablations for Colorectal Liver Metastases

et al. 2019

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Approximately 25% of colorectal cancers patients will develop hepatic metastases in the course of their disease. Surgical resection of hepatic metastases remains the first treatment choice for these patients, when feasible. However, only approximately 30% of metastatic lesions are resectable at the time of diagnosis. Thermal ablations have played an increasing role over the last few decades in the palliative and curative setting of colorectal liver metastases (CRLMs) in nonsurgical candidates with a liver-predominant disease. Several different techniques have been used to perform image-guided thermal ablations in the liver, including radiofrequency ablation, microwave ablation, cryoablation, and laser thermal ablation. We review the current ablation techniques, image-guidance modalities, indications, and debated topics of image-guided thermal ablation in CRLMs. Moreover, recent results from clinical trials are discussed along with future trends in liver thermal ablations.

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Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years’ experience

Cited by 21 publications

References 46 publications

Impact of primary tumour location on colorectal liver metastases: A systematic review

Impact of primary tumour location on colorectal liver metastases: A systematic review

Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matched analysis

Thermal Ablations for Colorectal Liver Metastases

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