Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review

Ong, Seok Ling; Gravante, Gianpiero; Metcalfe, Matthew S.; Strickland, Andrew; Dennison, Ashley R.; Lloyd, David M.

doi:10.1097/meg.0b013e328318ed04

Cited by 67 publications

(55 citation statements)

References 60 publications

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“…These findings indicate that despite a patient population of mainly cirrhotic individuals, operative MWA can be performed safely. This is underscored by multiple other series again highlighting the safety and effectiveness of operative MWA (14)(15)(16). Most important from this series, we evaluate our current results in comparison to our previously reported outcomes in 2013 (8).…”

Section: Discussionmentioning

confidence: 77%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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Background: Microwave ablation (MWA) of hepatocellular carcinoma (HCC) offers local regional treatment that can be safely and effectively performed, even in patients with advanced liver disease. We update results from our group's previous analysis of operative MWA for HCC. Results: Two hundred and nineteen patients were included with a total of 340 tumors treated with operative MWA. Median tumor size was 3.2 cm (range, 1-6 cm). Cirrhosis was present in 89.5% of patients, 60.7% had hepatitis C, and 8.2% had hepatitis B. Thirty-five point nine percent were Child-Pugh class B/C. Ninety-six point eight percent of MWA procedures were performed laparoscopically. Four deaths occurred within 30 days (1.8%). Clavien-Dindo grade III complications occurred in 3.2% of patients. Complete ablation was identified in 97.1% of tumors, with local recurrence rates of 8.5% at 10.9 months median follow up (0-80 months). Regional recurrence occurred in 34.8% of patients at 10.9 months median follow up and metastatic recurrence was seen in 8.1% of patients. One year overall survival was 80.0% and 2-year survival was 61.5%. Conclusions:We propose that laparoscopic MWA offers a low morbidity approach for treatment of HCC affording low rates of local recurrence even for patients with significant underlying liver dysfunction. This large series offers insight into outcomes of this modality as definitive treatment for patients with HCC.

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Section: Discussionmentioning

confidence: 77%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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“…Even if surgery and systemic chemotherapy are ineffective, they can lead to an increase in overall survival or, in the palliative setting, can result in an increased quality of life for the patient whilst having relatively few major complications and side effects. 48 Most therapies have developed over the years and lead to an increase in overall survival. Considering RFA, for example, Solbiati et al 38 documented an overall survival of 53.2 months, whereas Sorensen et al 32 who recruited a similar number of patients documented an overall survival of 32 months.…”

Section: Discussionmentioning

confidence: 99%

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

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The adequate treatment of non-resectable liver metastases from colorectal cancer which are resistant to systemic chemotherapy currently provides a great challenge. The aim is to identify and review key strategies in the treatment of colorectal liver metastases. A search for current literature on the topic of interventional strategies for colorectal metastases was performed in Medline in order to achieve this goal. Studies before 2005 and with ,20 patients treated for colorectal metastases were excluded. Transarterial chemoembolization (TACE), transarterial embolization and selective internal radiation therapy (SIRT) were identified as examples of regional strategies for colorectal liver metastases, utilizing the unique blood supply of the liver. Radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation were selected as examples for currently available ablative techniques. Median survival in the key studies reviewed ranged from 7.7 to 28.6 for TACE, 8.3-12.6 for SIRT, 8.2-53.2 for RFA and 29-43 months for MWA. After review of the literature, it can be concluded that interventional oncologic therapies are a safe and effective method for treating colorectal liver metastases. The use of new chemotherapeutic agents for local therapy and new ablation technologies and techniques may increase patient survival and allows a neoadjuvant therapy setting. In addition, a combination of local therapies may be used to increase effectiveness in the future, which is subject to further research. INTRODUCTIONColorectal cancer is one of the most common cancers that shows fatal progression.1 Colorectal carcinoma most commonly metastasises to the liver due to haematogenous spread.2 At the time of diagnosis, 20-30% of patients have liver metastases, and during the course of disease, up to 60% of patients develop hepatic metastases.3 Although surgical excision is the first-line treatment for colorectal metastases, only 10-25% of patients are candidates for surgical resection. 4 Neoadjuvant systemic chemotherapy only allows 10-30% of patients with unresectable colorectal liver metastases sufficient downsizing for resection.

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“…Microwave ablation-associated mortality was reported to occur in 0.002% according to a systematic review of this technique [60]. Major complication rates have been reported to be higher with MWA than with RFA in a randomised trial [61].…”

Section: Discussionmentioning

confidence: 99%

Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review

et al. 2011

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Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review

Cited by 67 publications

References 60 publications

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Current strategies in interventional oncology of colorectal liver metastases

Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review

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