Intraoperative Local Ablative Therapies Combined with Surgery for the Treatment of Bilobar Colorectal Liver Metastases

Anticancer Res. 2017 May;37(5):2743-2750. doi: 10.21873/anticanres.11626.

Abstract

Aim: To investigate the role of intraoperative local ablation techniques (LATs) in bilobar colorectal liver metastases (bCRLM).

Patients and methods: Among patients who underwent LAT for CRLM between 2005 and 2015, we selected 33 patients with bilobar disease submitted to thermal ablation alone or associated to liver resection. Primary end-point was complete local response at one month (CLR). Secondary end-points were morbidity, mortality, disease-free survival (DFS), local tumor recurrence (LTR) and long-term survival.

Results: CLR was observed in 100% of cases, while LTR occurred in 8 cases (22%). DFS at 1, 3 and 5 years was 37%, 5% and 5%. Overall survival (OS), in the same interval, was 95%, 49% and 26%. Univariate analysis found a significant correlation between LTR and tumor size (11% ≤20 mm vs. 50% >20 mm; p=0.009).

Conclusion: LAT is an effective adjuvant strategy in bCRLM for nodules within 20 mm diameter.

Keywords: Bilobar liver metastases; hepatic resection; local ablative therapy; local tumor recurrence; microwave; radiofrequency.

Publication types

  • Observational Study

MeSH terms

  • Ablation Techniques
  • Adult
  • Aged
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Survival Analysis
  • Tumor Burden