TY - JOUR
T1 - Efficacy of Thermal Ablation for Small-Size (0–3 cm) versus Intermediate-Size (3–5 cm) Colorectal Liver Metastases
T2 - Results from the Amsterdam Colorectal Liver Met Registry (AmCORE)
AU - Dijkstra, Madelon
AU - van der Lei, Susan
AU - Puijk, Robbert S.
AU - Schulz, Hannah H.
AU - Vos, Danielle J. W.
AU - Timmer, Florentine E. F.
AU - Scheffer, Hester J.
AU - Buffart, Tineke E.
AU - van den Tol, M. Petrousjka
AU - Lissenberg-Witte, Birgit I.
AU - Swijnenburg, Rutger-Jan
AU - Versteeg, Kathelijn S.
AU - Meijerink, Martijn R.
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Purpose: Thermal ablation is widely recognized as the standard of care for small-size unresectable colorectal liver metastases (CRLM). For larger CRLM safety, local control and overall efficacy are not well established and insufficiently validated. The purpose of this comparative series was to analyze outcomes for intermediate-size versus small-size CRLM. Material and methods: Patients treated with thermal ablation between December 2000 and November 2021 for small-size and intermediate-size CRLM were included. The primary endpoints were complication rate and local control (LC). Secondary endpoints included local tumor progression-free survival (LTPFS) and overall survival (OS). Results: In total, 59 patients were included in the intermediate-size (3–5 cm) group and 221 in the small-size (0–3 cm) group. Complications were not significantly different between the two groups (p = 0.546). No significant difference between the groups was found in an overall comparison of OS (HR 1.339; 95% CI 0.824–2.176; p = 0.239). LTPFS (HR 3.388; p < 0.001) and LC (HR 3.744; p = 0.004) were superior in the small-size group. Nevertheless, the 1-, 3-, and 5-year LC for intermediate-size CRLM was still 93.9%, 85.4%, and 81.5%, and technical efficacy improved over time. Conclusions: Thermal ablation for intermediate-size unresectable CRLM is safe and induces long-term LC in the vast majority. The results of the COLLISION-XL trial (unresectable colorectal liver metastases: stereotactic body radiotherapy versus microwave ablation—a phase II randomized controlled trial for CRLM 3–5 cm) are required to provide further clarification of the role of local ablative methods for intermediate-size unresectable CRLM.
AB - Purpose: Thermal ablation is widely recognized as the standard of care for small-size unresectable colorectal liver metastases (CRLM). For larger CRLM safety, local control and overall efficacy are not well established and insufficiently validated. The purpose of this comparative series was to analyze outcomes for intermediate-size versus small-size CRLM. Material and methods: Patients treated with thermal ablation between December 2000 and November 2021 for small-size and intermediate-size CRLM were included. The primary endpoints were complication rate and local control (LC). Secondary endpoints included local tumor progression-free survival (LTPFS) and overall survival (OS). Results: In total, 59 patients were included in the intermediate-size (3–5 cm) group and 221 in the small-size (0–3 cm) group. Complications were not significantly different between the two groups (p = 0.546). No significant difference between the groups was found in an overall comparison of OS (HR 1.339; 95% CI 0.824–2.176; p = 0.239). LTPFS (HR 3.388; p < 0.001) and LC (HR 3.744; p = 0.004) were superior in the small-size group. Nevertheless, the 1-, 3-, and 5-year LC for intermediate-size CRLM was still 93.9%, 85.4%, and 81.5%, and technical efficacy improved over time. Conclusions: Thermal ablation for intermediate-size unresectable CRLM is safe and induces long-term LC in the vast majority. The results of the COLLISION-XL trial (unresectable colorectal liver metastases: stereotactic body radiotherapy versus microwave ablation—a phase II randomized controlled trial for CRLM 3–5 cm) are required to provide further clarification of the role of local ablative methods for intermediate-size unresectable CRLM.
KW - colorectal liver metastases (CRLM)
KW - intermediate-size
KW - microwave ablation (MWA)
KW - radiofrequency ablation (RFA)
UR - http://www.scopus.com/inward/record.url?scp=85170359417&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers15174346
DO - https://doi.org/10.3390/cancers15174346
M3 - Article
C2 - 37686622
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 17
M1 - 4346
ER -