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Thermal ablation of liver metastases from colorectal cancer: radiofrequency, microwave and laser ablation therapies

La radiologia medica volume 119, pages 451–461 (2014)Cite this article

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.

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Authors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Thomas J. Vogl, Nagy N. N. Naguib, Abbas Darvishi, Babak Bazrafshan, Emmanuel Mbalisike, Thorsten Burkhard & Stephan Zangos

  2. Department of Radiology, Marienhospital, Osnabrück, Germany

    Parviz Farshid

  3. Department of Diagnostic and Interventional Radiology, Alexandria University, Alexandria, Egypt

    Nagy N. N. Naguib

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  1. Thomas J. Vogl
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  2. Parviz Farshid
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Vogl, T.J., Farshid, P., Naguib, N.N.N. et al. Thermal ablation of liver metastases from colorectal cancer: radiofrequency, microwave and laser ablation therapies. Radiol med 119, 451–461 (2014). https://doi.org/10.1007/s11547-014-0415-y

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Keywords

  • Colorectal cancer
  • Liver metastases
  • Radiofrequency ablation
  • Laser-induced thermotherapy
  • Microwave ablation