Outcomes after resection and/or radiofrequency ablation for recurrence after treatment of colorectal liver metastases

Hof, Joost; Wertenbroek, Marieke W. J. L. A. E.; Peeters, Paul; Widder, Joachim; Sieders, Egbert; Jong, de Steven

doi:10.1002/bjs.10162

Cited by 101 publications

(84 citation statements)

References 28 publications

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“…4). Fourteen studies compared RFA with surgery alone [13, 30–42], eight studies compared RFA + PH with PH alone [13, 15, 16, 18, 27, 28, 43, 44], and four studies compared RFA to RFA + PH or PH alone [13, 45–47]. A total number of 5020 patients were included in these observational studies (RFA: N = 1103; RFA + PH: N = 541; PH alone: N = 3376).…”

Section: Resultsmentioning

confidence: 99%

“…6) [13, 15, 16, 18, 27, 45, 46]. No significant difference in OS was found (HR = 1.24; 95%CI 0.84–1.84).…”

Section: Resultsmentioning

confidence: 99%

“…Govindarajan et al reported two deaths within 100-days post-resection in a group of 96 patients versus no deaths in the combination group [43]. Hof et al only reported the 30-day mortality rate for both interventions (5 of 707 patients) [13].

Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Median overall survival (OS) following systemic treatment nowadays reaches 20–22 months in patients who receive sequential chemotherapy regimens often with biological agents; 5-year survival remains < 15% [4–8]. Five-year survival following ablation varies between 17 and 53% [9–13]. Although recent studies [13–16] have reported similar survival for patients treated with thermal ablation or PH, interventional radiology and surgical oncology communities generally state that thermal ablation cannot be considered an alternative to PH.…”

Section: Introductionmentioning

confidence: 99%

“…Five-year survival following ablation varies between 17 and 53% [9–13]. Although recent studies [13–16] have reported similar survival for patients treated with thermal ablation or PH, interventional radiology and surgical oncology communities generally state that thermal ablation cannot be considered an alternative to PH. They recommend the use of open, laparoscopic or percutaneous RFA and MWA for small CRLM (≤ 3 cm) in patients who are unsuitable for resection due to (1) an impaired general health status (age, comorbidities), (2) a history of extensive abdominal surgery, (3) the presence of lesions with an unfavourable location or (4) an insufficient future liver remnant to resect all lesions [11, 17, 18].…”

Section: Introductionmentioning

confidence: 99%

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Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis

Meijerink

Puijk

Tilborg

et al. 2018

Cardiovasc Intervent Radiol

159

131

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PurposeTo assess safety and outcome of radiofrequency ablation (RFA) and microwave ablation (MWA) as compared to systemic chemotherapy and partial hepatectomy (PH) in the treatment of colorectal liver metastases (CRLM).MethodsMEDLINE, Embase and the Cochrane Library were searched. Randomized trials and comparative observational studies with multivariate analysis and/or matching were included. Guidelines from National Guideline Clearinghouse and Guidelines International Network were assessed using the AGREE II instrument.ResultsThe search revealed 3530 records; 328 were selected for full-text review; 48 were included: 8 systematic reviews, 2 randomized studies, 26 comparative observational studies, 2 guideline-articles and 10 case series; in addition 13 guidelines were evaluated. Literature to assess the effectiveness of ablation was limited. RFA + systemic chemotherapy was superior to chemotherapy alone. PH was superior to RFA alone but not to RFA + PH or to MWA. Compared to PH, RFA showed fewer complications, MWA did not. Outcomes were subject to residual confounding since ablation was only employed for unresectable disease.ConclusionThe results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone. Further randomized comparisons of ablation to current-day chemotherapy alone should therefore be considered unethical. Hence, the highest achievable level of evidence for unresectable CRLM seems reached. The apparent selection bias from previous studies and the superior safety profile mandate the setup of randomized controlled trials comparing ablation to surgery.Electronic supplementary materialThe online version of this article (10.1007/s00270-018-1959-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…6) [13, 15, 16, 18, 27, 45, 46]. No significant difference in OS was found (HR = 1.24; 95%CI 0.84–1.84).…”

Section: Resultsmentioning

confidence: 99%

Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis

Meijerink

Puijk

Tilborg

et al. 2018

Cardiovasc Intervent Radiol

159

131

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The role of surgical intervention for isolated breast cancer liver metastasis: Results of case‐control study with comparison to medical treatment

Wen

Xie

et al. 2020

Cancer Medicine

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BackgroundCombined with systemic therapy, the surgical intervention for breast cancer liver metastases (BCLM) is increasingly accepted but lacks convincing evidence. The aim of this study was to evaluate the disease control efficacy of hepatic surgery in isolated BCLM patients.MethodsBetween 2012 and 2017, metastatic breast cancer patients with isolated liver metastasis and regular follow‐up were identified. Cohort design was conducted to compare the progression‐free survival (PFS) between the surgical and nonsurgical BCLM patients. Univariate analysis and multivariate Cox regression survival analyses were performed to identify significant prognostic factors.ResultIn all, 148 isolated BCLM patients were enrolled and 95 participants received hepatic surgery for metastatic lesions. With median follow‐up of 36.47 months, there was no significant difference between hepatic surgical group and nonsurgical group for PFS (median PFS: 11.17 months vs 10.10 m, P = .092). Based on the multivariate analysis, the disease‐free interval (DFI) was an independent prognostic factor for isolated BCLM patients. Among the surgical group, BCLM patients who had ideal response after first salvage systemic treatment experienced the best long‐term survival (median PFS: 14.20 months).ConclusionFor isolated BCLM patients with ideal response in first‐line medical treatment, surgical intervention (hepatectomy, radiofrequency ablation) combining with systemic treatment could bring improved progression‐free survival compared to sole systemic treatment, indicating that hepatic surgery may be considered as a therapeutic choice for selected isolated BCLM patients in clinical practice.

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A novel prognostic nomogram for colorectal cancer liver metastasis patients with recurrence after hepatectomy

Liang

Lin

et al. 2021

Cancer Medicine

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Outcomes after resection and/or radiofrequency ablation for recurrence after treatment of colorectal liver metastases

Abstract: RFA had good oncological outcomes in patients with unresectable CRLMs. Radiofrequency ablation is progressively more applied with each additional intervention.

Cited by 101 publications

References 28 publications

Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis

Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis

The role of surgical intervention for isolated breast cancer liver metastasis: Results of case‐control study with comparison to medical treatment

A novel prognostic nomogram for colorectal cancer liver metastasis patients with recurrence after hepatectomy

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