Table.
Published studies of thermal ablation in the treatment of at least 50 colorectal liver metastases with an assessment of lesion size on efficacy
| Reference | Description of study | Number of lesions (patients) undergoing ablation and population description | Local recurrence rates (%): a) <3 cm b) >3 cm c) Any size |
Clinical details |
|---|---|---|---|---|
| Tanis et al., 2014 (17) | RFA arm of an RCT | 167 (55) All had prior systemic therapy. Unresectable CRLMs. No extra-hepatic disease |
a) 4/139 (2.9) b) 6/28 (21.4) c) 10/167 (6.0) |
4.7 years median follow-up 91.1% performed open |
| Abitabile et al., 2007 (11) | Case series RFA | 147 (47) Chemotherapy naïve. High surgical risk or unresectable CRLMs. Resectable extra-hepatic disease not a contraindication, but percentage not described |
a) 2/118 (1.7) b) 11/29 (37.8) c) 13/147 (8.8) |
2.8 years median follow-up 67.1% performed open |
| Kingham et al., 2012 (22) | Case series cryotherapy, RFA and MWA | 315 (158) Majority had prior chemotherapy (92%). Indications and presence of extra-hepatic disease not described |
c) 36/315 (11.4) | 1.4 years median follow-up All but one tumor ablated open Recurrence-free survival 92% ≤1 cm and 49% >3 cm |
| Hammill et al., 2011 (14) | Case series RFA | 236 (101) Majority had prior chemotherapy (82%). Resectable and unresectable CRLMs. No extra-hepatic disease |
a) 3/102 (2.9) b) 9/134 (6.7) c) 12/236 (5.1) |
2.6 year median follow-up All laparoscopic |
| Hamada et al., 2012 (20) | Case series RFA | 141 (84) Majority had prior chemotherapy (85%). Unresectable CRLMs or presence of extra-hepatic disease (27.4%) |
a) 15/106 (14.2) b) 24/35 (68.6) c) 39/141 (27.7) |
2.3 years median follow-up All percutaneous > 3 cm independent predictor of worse survival (HR, 2.30; CI, 1.15–4.61) |
| Shady et al., 2016 (25) | Case series RFA | 233 (165) Unclear how many had prior systemic chemotherapy. Resectable and unresectable CRLMs. 61% extra-hepatic disease |
c) 113/233 (48.5) | 4.6 years median follow-up All percutaneous > 3 cm independent predictor of local tumor progression (HR, 2.0; CI, 1.2–3.3) |
| Bale et al., 2012 (12) | Case series stereotactic RFA | 189 (63) Majority had prior chemotherapy (85%). Resectable and unresectable CRLMs. No extra-hepatic disease |
a) 23/130 (17.7) b) 8/59 (13.6) c) 31/189 (16.4) |
2.1 years median follow-up All percutaneous Tumor size no effect on DFS and OS |
| Kennedy et al., 2013 (15) | Case series RFA | 259 (130) Majority had prior chemotherapy (76%). Resectable and unresectable CRLMs. No extra-hepatic disease |
a) 3/84* (3.6) b) 9/46* (19.6) c) 12/130* (9.2) *per patient |
1.8 years median follow-up All laparoscopic > 2.9 cm worse OS (HR, 1.29; CI, 1.04–1.59) |
| Liu et al., 2017 (26) | Case series RFA and MWA | 83 (134) RFA; 18 (27) MWA 43.6% had prior chemotherapy. Resectable and unresectable CRLMs. Unclear if extra-hepatic disease present |
a) 25/124 (20.2) b) 11/19 (57.9) c) 36/143 (25.2) |
1.8 years mean follow-up All percutaneous >3 cm independent predictor of LTP (not the case with HCC— also assessed in this study) |
| Nielsen et al., 2013 (23) | Case series RFA | 282 (128) Unclear how many had prior chemotherapy. Resectable and unresectable CRLMs. Extra-hepatic disease not a contraindication if local control possible (% not described) |
a) 18/200 (9.0) b) 22/49 (44.9) c) 9/20 (45.0) |
3.0 years median follow-up All open Trend towards worse survival > 3 cm (median 37 vs. 45 months, p = 0.118) |
| Vogl et al., 2014 (27) | Case series LITT | 1545 (594) 36% had prior chemotherapy. Resectable and unresectable CRLMs. 23% extra-hepatic disease |
c) 2/594 (2.0)* *per patient |
1.9 years mean follow-up All percutaneous Maximal metastasis diameter associated with worse OS and PFS |
| Qin et al., 2018 (24) | Case series MWA | 411 Majority had prior chemotherapy (74%). Unclear if CRLMs were resectable or unresectable. 25% extra-hepatic disease |
a) 17/398 (4.3) b) 5/13 (38.5) c) 22/411 (5.4) |
1.5 years median follow-up All percutaneous |
| Solbiati et al., 2012 (16) | Case series RFA | 202 (99) All patients received adjuvant chemotherapy. Resectable and unresectable CRLMs. Oligonodular (< 3) lung disease not a contraindication (percentage not described) |
c) 32/99 (32.3)* *per patient |
4.4 years median follow-up All percutaneous No significant effect of tumor size on LTP, new metastases or overall survival (only 11 lesions >3 cm) |
| Valls et al., 2014 (18) | Case series RFA | 91 (59) Unclear how many received chemotherapy. Unresectable CRLMs. Resectable lung metastases not a contraindication (percentage not described) |
a) 4/66 (6.1) b) 13/25 (52.0) c) 17/91 (18.7) |
2.1 years median follow-up All percutaneous and prior hepatic resection Size > 3 cm an independent risk factor for local recurrence |
| Van Tilborg et al., 2011 (19) | Case series RFA | 237 (100) 43% prior chemotherapy. Unresectable CRLMs. 7% had curable extra-hepatic disease |
a) 8/143 (5.6) b) 22/94 (23.4) c) 30/237 (12.7) |
2.4 years mean follow-up 93.2 % performed open Size a predictor of mean survival |
| Veltri et al., 2008 (10) | Case series RFA | 186 (122) Majority had prior chemotherapy (71%). Unresectable CRLMs. 21% extra-hepatic disease |
a) (33.3)* b) (66.7)* c) 49/186 (26.3) *includes residual unablated tumor |
2.0 years mean follow-up 13.0% laparoscopic 21 lesions performed with “ischemic maneuvers” including 5 TACE |
| Veltri et al., 2012 (9) | Case series RFA | 458 (262) Unclear how many had chemotherapy Unresectable CRLMs. 20% extra-hepatic disease |
2.2 years mean follow-up 7.3% laparoscopic Worse survival >3 cm (21.7 months; CI, 16.6–27.4 vs. 41 months; CI, 32.6–49.7) |
|
| Gu et al., 2018 (13) | Case series RFA | 185 (102) Majority had chemotherapy following RFA (64%). Unresectable CRLMs. No extra-hepatic disease |
c) 29/185 (15.7) | All percutaneous > 3 cm worse OS (HR, 3.9; CI, 1.4–8.8) |
An Ovid Medline search was performed with studies limited to English language and at least 50 participating patients. Where boxes are empty, the data are not reported. Recurrence rates are per lesion unless otherwise stated.
RFA, radiofrequency ablation; RCT, randomized controlled trial; CRLMs, colorectal cancer liver metastases; MWA, microwave ablation; HR, hazard ratio; CI, 95% confidence interval; DFS, disease-free survival; OS, overall survival; LTP, local tumor progression; HCC, hepatocellular carcinoma; LITT, laser-induced interstitial thermotherapy; PFS, progression-free survival; TACE, transarterial chemoembolization.