title: Thermal ablation of liver metastases from colorectal cancer: radiofrequency, microwave and laser ablation therapies.
abstract: Surgery is currently considered the treatment of choice for patients with colorectal cancer liver metastases (CRLM) when resectable. The majority of these patients can also benefit from systemic chemotherapy. Recently, local or regional therapies such as thermal ablations have been used with acceptable outcomes. We searched the medical literature to identify studies and reviews relevant to radiofrequency (RF) ablation, microwave (MW) ablation and laser-induced thermotherapy (LITT) in terms of local progression, survival indexes and major complications in patients with CRLM. Reviewed literature showed a local progression rate between 2.8 and 29.7 % of RF-ablated liver lesions at 12-49 months follow-up, 2.7-12.5 % of MW ablated lesions at 5-19 months follow-up and 5.2 % of lesions treated with LITT at 6-month follow-up. Major complications were observed in 4-33 % of patients treated with RF ablation, 0-19 % of patients treated with MW ablation and 0.1-3.5 % of lesions treated with LITT. Although not significantly different, the mean of 1-, 3- and 5-year survival rates for RF-, MW- and laser ablated lesions was (92.6, 44.7, 31.1 %), (79, 38.6, 21 %) and (94.2, 61.5, 29.2 %), respectively. The median survival in these methods was 33.2, 29.5 and 33.7 months, respectively. Thermal ablation may be an appropriate alternative in patients with CRLM who have inoperable liver lesions or have operable lesions as an adjunct to resection. However, further competitive evaluation should clarify the efficacy and priority of these therapies in patients with colorectal cancer liver metastases.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany, t.vogl@em.uni-frankfurt.de.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Parviz
authors.initials: P
authors.lastname: Farshid
authors.forename: Nagy N N
authors.initials: NN
authors.lastname: Naguib
authors.forename: Abbas
authors.initials: A
authors.lastname: Darvishi
authors.forename: Babak
authors.initials: B
authors.lastname: Bazrafshan
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mbalisike
authors.forename: Thorsten
authors.initials: T
authors.lastname: Burkhard
authors.forename: Stephan
authors.initials: S
authors.lastname: Zangos
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003952:Diagnostic Imaging; D018450:Disease Progression; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use*; D011183:Postoperative Complications; D015996:Survival Rate