Role of thermal ablation in the management of colorectal liver metastasis.

Hepatobiliary Surgery and Nutrition
Hideo Takahashi, Eren Berber

Abstract

With a recent randomized prospective trial revealing that thermal ablative therapy as local tumor control improved overall survival (OS) in patients with unresectable colorectal cancer liver metastases (CRLM), thermal ablation continues to remain as an important treatment option in this patient population. Our aim of this article is to review the current role of the ablative therapy in the management of CRLM patients. Main indications for thermal ablation include (I) unresectable liver lesions; (II) in combination with hepatectomy; (III) in patients with significant medical comorbidities or poor performance status (PS); (IV) a small (<3 cm) solitary lesion, which would otherwise necessitate a major liver resection; and (V) patient preference. There are several approaches and modalities for ablative therapy, including open, percutaneous, and laparoscopic approaches, as well as radiofrequency ablation (RFA) and microwave ablation (MWA). Each approach and ablation modality have its own pros and cons. Percutaneous and laparoscopic approaches are preferred due to minimally invasive nature, yet laparoscopic approach has more benefits from thorough intraoperative ultrasound (US) exam as well as complete peritoneal staging with laparos...Continue Reading

Citations

May 21, 2020·International Journal of Molecular Sciences·Aldona Kasprzak, Agnieszka Adamek
Jan 17, 2021·International Journal of Radiation Oncology, Biology, Physics·Alejandra Méndez RomeroJeroen Buijsen
Mar 5, 2021·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Yunzhu DaiRuhai Zou

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