title: MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts.
abstract: OBJECTIVE
  To retrospectively analyse the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) in the treatment of unresectable colorectal liver metastases (CRLM) in proximity to large vessels and/or major bile ducts.
  
  
  METHODS
  A database search was performed to include patients with unresectable histologically proven and/or (18)F-FDG-PET avid CRLM who were treated with RFA or MWA between January 2001 and September 2014 in a single centre. All lesions that were considered to have a peribiliary and/or perivascular location were included. Univariate logistic regression analysis was performed to assess the distribution of patient, tumour and procedure characteristics. Multivariate logistic regression was used to correct for potential confounders.
  
  
  RESULTS
  Two hundred and forty-three patients with 774 unresectable CRLM were ablated. One hundred and twenty-two patients (78 males; 44 females) had at least one perivascular or peribiliary lesion (n = 199). Primary efficacy rate of RFA was superior to MWA after 3 and 12 months of follow-up (P = 0.010 and P = 0.022); however, after multivariate analysis this difference was non-significant at 12 months (P = 0.078) and vanished after repeat ablations (P = 0.39). More CTCAE grade III complications occurred after MWA versus RFA (18.8 vs. 7.9 %; P = 0.094); biliary complications were especially common after peribiliary MWA (P = 0.002).
  
  
  CONCLUSIONS
  For perivascular CRLM, RFA and MWA are both safe treatment options that appear equally effective. For peribiliary CRLM, MWA has a higher complication rate than RFA, with similar efficacy. Based on these results, it is advised to use RFA for lesions in the proximity of major bile ducts.
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands. a.vantilborg@vumc.nl.
authors.forename: Aukje A J M
authors.initials: AA
authors.lastname: van Tilborg
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands.
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Scheffer
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands.
authors.forename: Marcus C
authors.initials: MC
authors.lastname: de Jong
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands.
authors.forename: Laurien G P H
authors.initials: LG
authors.lastname: Vroomen
authors.affiliation: Department of Surgical Oncology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands.
authors.forename: Cornelis
authors.initials: C
authors.lastname: van Kuijk
authors.affiliation: Department of Surgical Oncology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Petrousjka M P
authors.initials: PM
authors.lastname: van den Tol
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, The Netherlands.
authors.forename: Martijn R
authors.initials: MR
authors.lastname: Meijerink
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Ablation; Colorectal liver metastases; Microwave; Peribiliary; Perivascular; Radiofrequency