Efficacy of Thermal Ablation for Small-Size (0-3 cm) versus Intermediate-Size (3-5 cm) Colorectal Liver Metastases: Results from the Amsterdam Colorectal Liver Met Registry (AmCORE).
Autor: | Dijkstra M; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., van der Lei S; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., Puijk RS; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., Schulz HH; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., Vos DJW; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., Timmer FEF; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands., Scheffer HJ; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Noordwest Ziekenhuisgroep, 1815 JD Alkmaar, The Netherlands., Buffart TE; Department of Medical Oncology, Amsterdam University Medical Centers, Location VUmc, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands., van den Tol MP; Department of Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands., Lissenberg-Witte BI; Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands., Swijnenburg RJ; Department of Surgery, Amsterdam University Medical Centers, Location VUmc, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands., Versteeg KS; Department of Medical Oncology, Amsterdam University Medical Centers, Location VUmc, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands., Meijerink MR; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands. |
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Jazyk: | angličtina |
Zdroj: | Cancers [Cancers (Basel)] 2023 Aug 31; Vol. 15 (17). Date of Electronic Publication: 2023 Aug 31. |
DOI: | 10.3390/cancers15174346 |
Abstrakt: | 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. |
Databáze: | MEDLINE |
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