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Computed tomography-guided microwave ablation of perivascular liver metastases from colorectal cancer: a study of the ablation zone, feasibility, and safety

Abstract : Objectives: To compare the ablation margins and safety of microwave ablation (MWA) of perivascular versus non-perivascular liver metastases from colorectal cancer (CRC) and to determine the risk factors for local tumor progression (LTP) after perivascular MWA. Methods: Between June 2017 and June 2019, 84 metastases were treated: 39 perivascular (<5 mm from a vessel >3 mm), and 46 non-perivascular. Perivascular metastases were treated with either conventional or optimized protocols (maximum power and/or several heating cycles after repositioning the needle regardless of the initial tumor dimensions). The mean diameter of metastases was 15.4 mm (SD: 7.56). Results: Vascular proximity did not result in a significant difference in ablation margins. The technical success rate, primary efficacy, and secondary efficacy were 90%, 66%, and 83%, respectively. Perivascular location was not a risk factor for time to LTP (p ¼ 0.49), RFS (p ¼ 0.52), or OS (p ¼ 0.54). LTP was statistically related to the presence of a colonic obstruction (p < 0.05), number of metastases at the time of diagnosis (p < 0.05), type of protocol (p < 0.05), ablation margins (p < 0.001) and LTP was proportional to the number of liver resections before MWA (p < 0.05). There was no LTP in tumors ablated with margins over 10 mm. Two grade 4 complications occurred. Conclusion: MWA is an effective and safe treatment for perivascular liver metastases from CRC, provided that satisfactory margins are achieved. A maximalist attitude could be related to better local control.
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Submitted on : Wednesday, March 16, 2022 - 6:20:25 PM
Last modification on : Friday, July 1, 2022 - 3:37:21 AM
Long-term archiving on: : Friday, June 17, 2022 - 7:44:40 PM

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Jean Izaaryene, Maxime Drai, Cécile Deniel, Pauline Bridge, Geoffrey Rico, et al.. Computed tomography-guided microwave ablation of perivascular liver metastases from colorectal cancer: a study of the ablation zone, feasibility, and safety. International Journal of Hyperthermia, Taylor & Francis, 2021, 38 (1), pp.887 - 899. ⟨10.1080/02656736.2021.1912413⟩. ⟨hal-03611059⟩

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