The Combination of Transarterial Chemoembolization and Microwave Ablation is Superior to Microwave Ablation Alone for Liver Metastases from Colorectal Cancer

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2024 Oct 1

PMID 39354218

Authors

Thomas J Vogl

Hannah Stefan

Tatjana Gruber-Rouh

Jorg Trojan

Wolf Otto Bechstein

John Bielfeldt

Hamzah Adwan

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to compare the combination therapy of transarterial chemoembolization (TACE) and microwave ablation (MWA) with MWA alone in treating liver metastases from colorectal cancer (LMCRC).

Materials And Methods: In this retrospective study, a total of 251 patients with unresectable and not to chemotherapy responding LMCRC were included. Group A consisted of 184 patients (104 male and 80 females; mean age: 64 ± 11.4 years) with 442 metastases who received a combination of TACE and MWA. A total of 67 patients (49 male and 18 females; mean age: 63.2 ± 11.8 years) with 173 metastases patients were included in group B, who received only MWA. Parameters assessed were local tumor progression (LTP), hepatic distant tumor progression (hDTP), hepatic progression-free survival (hPFS), and overall survival (OS).

Results: The rate of LTP was 4.9% in group A and 4.5% in group B (p-value: 0.062). The rate of hDTP was 71.7% and 83.6% for groups A and B (p-value: 0.81), respectively. The mean hPFS was 13.8 months (95% CI 10.9-16.8) for group A and 8.1 months (95% CI 6.1-10.1) for group B (p-value: 0.03). The median OS time for group A was 30 months (95% CI 26-34), with 1-, 2-, 3-, and 4-year OS rates of 84.2%, 61.1%, 40.8% and 31.3%, respectively. In group B however, the median OS time was 26 months (95% CI 18-34) with 1-, 2-, 3-, and 4-year OS rates of 82.3%, 53.2%, 34.6% and 28.2%, respectively (p-value: 0.67).

Conclusion: The combination therapy of TACE and MWA is superior to the monotherapy of MWA for LMCRC, especially regarding hDTP, hPFS and OS.

References

Liu C, Li T, He J, Shao H . TACE combined with microwave ablation therapy vs. TACE alone for treatment of early- and intermediate-stage hepatocellular carcinomas larger than 5 cm: a meta-analysis. Diagn Interv Radiol. 2020; 26(6):575-583. PMC: 7664747. DOI: 10.5152/dir.2020.19615. View

Eisenhauer E, Therasse P, Bogaerts J, Schwartz L, Sargent D, Ford R . New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2008; 45(2):228-47. DOI: 10.1016/j.ejca.2008.10.026. View

Bray F, Laversanne M, Sung H, Ferlay J, Siegel R, Soerjomataram I . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74(3):229-263. DOI: 10.3322/caac.21834. View

Gruber-Rouh T, Marko C, Thalhammer A, Nour-Eldin N, Langenbach M, Beeres M . Current strategies in interventional oncology of colorectal liver metastases. Br J Radiol. 2016; 89(1064):20151060. PMC: 5124876. DOI: 10.1259/bjr.20151060. View

Gruber-Rouh T, Schmitt C, Naguib N, Nour-Eldin N, Eichler K, Beeres M . Transarterial chemoembolization (TACE) using mitomycin and lipiodol with or without degradable starch microspheres for hepatocellular carcinoma: comparative study. BMC Cancer. 2018; 18(1):188. PMC: 5813391. DOI: 10.1186/s12885-018-4099-x. View

Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S . Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology. 1983; 148(2):397-401. DOI: 10.1148/radiology.148.2.6306721. View

Fong Z, Palazzo F, Needleman L, Brown D, Eschelman D, Chojnacki K . Combined hepatic arterial embolization and hepatic ablation for unresectable colorectal metastases to the liver. Am Surg. 2012; 78(11):1243-8. View

Eickhoff A, Hartmann D, Jakobs R, Schilling D, Adamek H, Kohler B . [Prevention and Screening in Colorectal Cancer]. Dtsch Med Wochenschr. 2018; 143(2):115-122. DOI: 10.1055/s-0043-124737. View

Lahat E, Eshkenazy R, Zendel A, Zakai B, Maor M, Dreznik Y . Complications after percutaneous ablation of liver tumors: a systematic review. Hepatobiliary Surg Nutr. 2014; 3(5):317-23. PMC: 4207846. DOI: 10.3978/j.issn.2304-3881.2014.09.07. View

10.

Yang Y, Yu H, Qi L, Liu C, Feng Y, Qi J . Combined radiofrequency ablation or microwave ablation with transarterial chemoembolization can increase efficiency in intermediate-stage hepatocellular carcinoma without more complication: a systematic review and meta-analysis. Int J Hyperthermia. 2022; 39(1):455-465. DOI: 10.1080/02656736.2022.2048095. View

11.

Thelen A, Jonas S, Benckert C, Schumacher G, Lopez-Hanninen E, Rudolph B . Repeat liver resection for recurrent liver metastases from colorectal cancer. Eur J Surg Oncol. 2006; 33(3):324-8. DOI: 10.1016/j.ejso.2006.10.016. View

12.

Massmann A, Rodt T, Marquardt S, Seidel R, Thomas K, Wacker F . Transarterial chemoembolization (TACE) for colorectal liver metastases--current status and critical review. Langenbecks Arch Surg. 2015; 400(6):641-59. DOI: 10.1007/s00423-015-1308-9. View

13.

Wang X, Sofocleous C, Erinjeri J, Petre E, Gonen M, Do K . Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases. Cardiovasc Intervent Radiol. 2012; 36(1):166-75. PMC: 4122121. DOI: 10.1007/s00270-012-0377-1. View

14.

Brace C . Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences?. Curr Probl Diagn Radiol. 2009; 38(3):135-43. PMC: 2941203. DOI: 10.1067/j.cpradiol.2007.10.001. View

15.

Stattner S, Jones R, Yip V, Buchanan K, Poston G, Malik H . Microwave ablation with or without resection for colorectal liver metastases. Eur J Surg Oncol. 2013; 39(8):844-9. DOI: 10.1016/j.ejso.2013.04.005. View

16.

Acciuffi S, Meyer F, Bauschke A, Croner R, Settmacher U, Altendorf-Hofmann A . Solitary colorectal liver metastasis: overview of treatment strategies and role of prognostic factors. J Cancer Res Clin Oncol. 2021; 148(3):657-665. PMC: 8881245. DOI: 10.1007/s00432-021-03880-4. View

17.

Vogl T, Lahrsow M . The Role of Conventional TACE (cTACE) and DEBIRI-TACE in Colorectal Cancer Liver Metastases. Cancers (Basel). 2022; 14(6). PMC: 8946099. DOI: 10.3390/cancers14061503. View

18.

Sacks D, McClenny T, Cardella J, Lewis C . Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2003; 14(9 Pt 2):S199-202. DOI: 10.1097/01.rvi.0000094584.83406.3e. View

19.

Groeschl R, Pilgrim C, Hanna E, Simo K, Swan R, Sindram D . Microwave ablation for hepatic malignancies: a multiinstitutional analysis. Ann Surg. 2013; 259(6):1195-200. DOI: 10.1097/SLA.0000000000000234. View

20.

Kwan J, Pua U . Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis. Cancers (Basel). 2021; 13(6). PMC: 8003062. DOI: 10.3390/cancers13061371. View