title: Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, The Interventional Oncology Sans Frontières meeting 2013.
abstract: OBJECTIVE
  Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases.
  
  
  METHODS
  This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented.
  
  
  RESULTS
  Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable.
  
  
  CONCLUSIONS
  In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology.
  
  
  CONCLUSIONS
  • Best results require due consideration of tumour size, number, volume and location. • Ablation technology, imaging guidance and intra-procedural imaging assessment must be optimised. • Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve. • Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach. • Future applications may include resectable disease, e.g. for small solitary tumours.
authors.affiliation: Imaging Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, UK. alliesorting@gmail.com.
authors.forename: Alice
authors.identifier: http://orcid.org/0000-0001-9118-0112
authors.initials: A
authors.lastname: Gillams
authors.affiliation: Beth Israel Deaconess Medical Centre, Boston, MA, USA.
authors.forename: Nahum
authors.initials: N
authors.lastname: Goldberg
authors.affiliation: Beth Israel Deaconess Medical Centre, Boston, MA, USA.
authors.forename: Muneeb
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Innsbruck University Hospital, Innsbruck, Austria.
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
authors.affiliation: Southampton University Hospital, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Breen
authors.affiliation: The Mayo Clinic, Rochester, MN, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Callstrom
authors.affiliation: Peking University Hospital, Beijing, China.
authors.forename: Min Hua
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Seoul University Hospital, Seoul, Korea.
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
authors.affiliation: , Gustave Roussy Cancer Campus, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baere
authors.affiliation: , Rhode Island, RI, USA.
authors.forename: Damian
authors.initials: D
authors.lastname: Dupuy
authors.affiliation: University of Strasbourg, Strasbourg, France.
authors.forename: Afshin
authors.initials: A
authors.lastname: Gangi
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Gervais
authors.affiliation: Klinikum Bochenhausen, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Helmberger
authors.affiliation: University of Regensburg, Regensburg, Germany.
authors.forename: Ernst-Michael
authors.initials: EM
authors.lastname: Jung
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Lee
authors.affiliation: University of Pisa, Pisa, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lencioni
authors.affiliation: Chinese PLA General Hospital, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.affiliation: Clinical Institute Humanitas, Rozzano Milano, Milan, Italy.
authors.forename: Tito
authors.initials: T
authors.lastname: Livraghi
authors.affiliation: UCLA, Los Angeles, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lu
authors.affiliation: University of Milan, Milan, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Meloni
authors.affiliation: University of Heidelberg, Heidelberg, Germany.
authors.forename: Philippe
authors.initials: P
authors.lastname: Pereira
authors.affiliation: University of Bologna, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
authors.affiliation: Sungkyunkwan University, Seoul, Korea.
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Riad
authors.initials: R
authors.lastname: Salem
authors.affiliation: Memorial Sloane Kettering, New York, NY, USA.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Sofocleous
authors.affiliation: Memorial Sloane Kettering, New York, NY, USA.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Soulen
authors.affiliation: Yokokura Hospital, Miyama, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: University of Frankfurt, Frankfurt, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogl
authors.affiliation: National Institute for Health, Bethesda, MD, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Wood
authors.affiliation: , Busto Arsizio, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Solbiati
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D016019:Survival Analysis
keywords: Ablation techniques; Clinical protocols; Colorectal neoplasms; Consensus; Liver neoplasms