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Evolution of surgical microwave ablation for the treatment of colorectal cancer liver metastasis: review of the literature and a single centre experience

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Abstract

Surgical resection is the gold standard treatment for colorectal liver metastasis, with reported five-year survival rates of 40 %. Unfortunately, despite progress in systemic therapies and surgical techniques, only 20–30 % of patients can be offered this potentially curative treatment modality. Ablative therapies have recently been suggested to treat unresectable lesions or to extend the margins of resectability. Additionally, cases of local recurrence after hepatic surgery might require alternative strategies and options for re-intervention. Microwave ablation (MWA) has recently become a matter of particular interest for such indications. We, herein, present a review of the literature published between January 1999 and June 2013 from a database search with the following keywords: microwave, ablation, liver metastases, colorectal neoplasm, resection, hepatectomy, colonic neoplasm, cancer. Furthermore, we provide insight based on our own data for 28 consecutive patients who underwent hepatic resection combined with MWA from 2005 to 2012 in a single centre.

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References

  1. Poston GJ, Tait D, O’Connell S, Bennett A, Berendse S. Diagnosis and management of colorectal cancer: summary of NICE guidance. BMJ. 2011;343:d6751.

    Article  CAS  PubMed  Google Scholar 

  2. Cirocchi R, Trastulli S, Boselli C, Montedori A, Cavaliere D, Parisi A, et al. Radiofrequency ablation in the treatment of liver metastases from colorectal cancer. Cochrane Database Syst Rev. 2012;6:CD006317.

    PubMed  Google Scholar 

  3. Jones C, Badger SA, Ellis G. The role of microwave ablation in the management of hepatic colorectal metastases. Surgeon. 2011;9:33–7.

    Article  CAS  PubMed  Google Scholar 

  4. Hugh TJ, Kinsella AR, Poston GJ. Management strategies for colorectal liver metastases: part II. Surg Oncol. 1997;6:31–48.

    Article  CAS  PubMed  Google Scholar 

  5. Pawlik TM, Choti MA. Surgical therapy for colorectal metastases to the liver. J Gastrointest Surg. 2007;11:1057–77.

    Article  PubMed  Google Scholar 

  6. Jones RP, Jackson R, Dunne DF, Malik HZ, Fenwick SW, Poston GJ, et al. Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases. Br J Surg. 2012;99:477–86.

    Article  CAS  PubMed  Google Scholar 

  7. Adam R, Avisar E, Ariche A, Giachetti S, Azoulay D, Castaing D, et al. Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal [liver] metastases. Ann Surg Oncol. 2001;8:347–53.

    Article  CAS  PubMed  Google Scholar 

  8. Bismuth H, Adam R, Levi F, Farabos C, Waechter F, Castaing D, et al. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg. 1996;224:509–20.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Abdalla EK, Hicks ME, Vauthey JN. Portal vein embolization: rationale, technique and future prospects. Br J Surg. 2001;88:165–75.

    Article  CAS  PubMed  Google Scholar 

  10. Azoulay D, Castaing D, Smail A, Adam R, Cailliez V, Laurent A, et al. Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization. Ann Surg. 2000;231:480–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Adam R, Laurent A, Azoulay D, Castaing D, Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann Surg. 2000;232:777–85.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Kianmanesh R, Farges O, Abdalla EK, Sauvanet A, Ruszniewski P, Belghiti J. Right portal vein ligation: a new planned two-step all-surgical approach for complete resection of primary gastrointestinal tumors with multiple bilateral liver metastases. J Am Coll Surg. 2003;197:164–70.

    Article  PubMed  Google Scholar 

  13. Stättner S, Yip V, Jones RP, Lacasia C, Fenwick SW, Poston GJ, et al. Liver resection with concomitant inferior vena cava resection: experiences without veno-venous bypass. Surg Today. 2013. doi:10.1007/s00595-013-0652-z.

  14. Derek E, Matsuoka L, Alexopoulos S, Fedenko A, Genyk Y, Selby R. Combined surgical resection and radiofrequency ablation as treatment for metastatic ocular melanoma. Surg Today. 2013;43(4):367–71.

    Article  PubMed  Google Scholar 

  15. Wong SL, Mangu PB, Choti MA, et al. American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer. J Clin Oncol. 2010;28(3):493–508.

    Article  PubMed  Google Scholar 

  16. NICE. Microwave ablation for the treatment of liver metastases 2011(Aug), p. N2640. Available at: http://www.nice.org.uk.

  17. Pathak S, Jones R, Tang JM, Parmar C, Fenwick S, Malik H, et al. Ablative therapies for colorectal liver metastases: a systematic review. Colorectal Dis. 2011;13:e252–65.

    Article  CAS  PubMed  Google Scholar 

  18. Ruers T, Punt C, Van Coevorden F, Pierie JP, Borel-Rinkes I, Ledermann JA, et al. Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol. 2012;23:2619–26.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Evrard S, Rivoire M, Arnaud J, Lermite E, Bellera C, Fonck M, et al. Unresectable colorectal cancer liver metastases treated by intraoperative radiofrequency ablation with or without resection. Br J Surg. 2012;99:558–65.

    Article  CAS  PubMed  Google Scholar 

  20. Rocha FG, D’Angelica M. Treatment of liver colorectal metastases: role of laparoscopy, radiofrequency ablation, and microwave coagulation. J Surg Oncol. 2010;102:968–74.

    Article  PubMed  Google Scholar 

  21. Gravante G, Ong SL, Metcalfe MS, Strickland A, Dennison AR, Lloyd DM. Hepatic microwave ablation: a review of the histological changes following thermal damage. Liver Int. 2008;28:911–21.

    Article  PubMed  Google Scholar 

  22. Tabuse K. A new operative procedure of hepatic surgery using a microwave tissue coagulator. Nihon Geka Hokan. 1979;48:160–72.

    CAS  PubMed  Google Scholar 

  23. Ong SL, Gravante G, Metcalfe MS, Strickland AD, Dennison AR, Lloyd DM. Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review. Eur J Gastroenterol Hepatol. 2009;21:599–605.

    Article  PubMed  Google Scholar 

  24. Hoffmann R, Rempp H, Clasen S. Microwave tumor ablation. New devices, new applications? Radiologe. 2012;52:22–8.

    Article  CAS  PubMed  Google Scholar 

  25. Jones RP, Kitteringham NR, Terlizzo M, Hancock C, Dunne D, Fenwick SW, et al. Microwave ablation of ex vivo human liver and colorectal liver metastases with a novel 14.5 GHz generator. Int J Hyperthermia. 2012;28:43–54.

    Article  PubMed  Google Scholar 

  26. Ohmoto K, Yoshioka N, Tomiyama Y, Shibata N, Kawase T, Yoshida K, et al. Radiofrequency ablation versus percutaneous microwave coagulation therapy for small hepatocellular carcinomas: a retrospective comparative study. Hepatogastroenterology. 2007;54:985–9.

    PubMed  Google Scholar 

  27. Lu MD, Xu HX, Xie XY, Yin XY, Chen JW, Kuang M, et al. Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol. 2005;40:1054–60.

    Article  PubMed  Google Scholar 

  28. Dong B, Liang P, Yu X, Su L, Yu D, Cheng Z, et al. Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol. 2003;180:1547–55.

    Article  PubMed  Google Scholar 

  29. Shibata T, Iimuro Y, Yamamoto Y, Maetani Y, Ametani F, Itoh K, et al. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology. 2002;223:331–7.

    Article  PubMed  Google Scholar 

  30. Seki T, Tamai T, Nakagawa T, Imamura M, Nishimura A, Yamashiki N, et al. Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma. Cancer. 2000;89:1245–51.

    Article  CAS  PubMed  Google Scholar 

  31. Kuang M, Lu MD, Xie XY, Xu HX, Mo LQ, Liu GJ, et al. Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna–experimental and clinical studies. Radiology. 2007;242:914–24.

    Article  PubMed  Google Scholar 

  32. Shibata T, Niinobu T, Ogata N, Takami M. Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer. 2000;89:276–84.

    Article  CAS  PubMed  Google Scholar 

  33. Tanaka K, Shimada H, Nagano Y, Endo I, Sekido H, Togo S. Outcome after hepatic resection versus combined resection and microwave ablation for multiple bilobar colorectal metastases to the liver. Surgery. 2006;139:263–73.

    Article  PubMed  Google Scholar 

  34. Iannitti DA, Martin RC, Simon CJ, Hope WW, Newcomb WL, McMasters KM, et al. Hepatic tumor ablation with clustered microwave antennae: the US Phase II trial. HPB (Oxford). 2007;9:120–4.

    Article  Google Scholar 

  35. Martin RC, Scoggins CR, McMasters KM. Safety and efficacy of microwave ablation of hepatic tumors: a prospective review of a 5-year experience. Ann Surg Oncol. 2010;17:171–8.

    Article  PubMed  Google Scholar 

  36. Jagad RB, Koshariya M, Kawamoto J, Papastratis P, Kefalourous H, Patris V, et al. Laparoscopic microwave ablation of liver tumors: our experience. Hepatogastroenterology. 2008;55:27–32.

    PubMed  Google Scholar 

  37. Bhardwaj N, Strickland AD, Ahmad F, El-Abassy M, Morgan B, Robertson GS, et al. Microwave ablation for unresectable hepatic tumours: clinical results using a novel microwave probe and generator. Eur J Surg Oncol. 2010;36:264–8.

    Article  CAS  PubMed  Google Scholar 

  38. Livraghi T, Meloni F, Solbiati L, Zanus G. Complications of microwave ablation for liver tumors: results of a multicenter study. Cardiovasc Intervent Radiol. 2012;35:868–74.

    Article  PubMed  Google Scholar 

  39. Seki T, Wakabayashi M, Nakagawa T, Imamura M, Tamai T, Nishimura A, et al. Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study. Am J Gastroenterol. 1999;94:322–7.

    Article  CAS  PubMed  Google Scholar 

  40. Morita T, Shibata T, Okuyama M, Ikeda K, Tsukahara Y, Kitada M, et al. Microwave coagulation therapy for liver metastases from colorectal cancer. Gan To Kagaku Ryoho. 2004;31:695–9.

    PubMed  Google Scholar 

  41. Karanicolas PJ, Jarnagin WR, Gonen M, Tuorto S, Allen PJ, Dematteo RP, et al. Long-term outcomes following tumor ablation for treatment of bilateral colorectal liver metastases. JAMA Surg. 2013;148:597–601.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Dodd GD 3rd, Dodd NA, Lanctot AC, Glueck DA. Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model. Radiology. 2013;267:129–36.

    Article  PubMed  Google Scholar 

  43. Bhardwaj N, Dormer J, Ahmad F, Strickland AD, Gravante G, West K, et al. Microwave ablation of the liver: a description of lesion evolution over time and an investigation of the heat sink effect. Pathology. 2011;43:725–31.

    Article  CAS  PubMed  Google Scholar 

  44. Yu NC, Raman SS, Kim YJ, Lassman C, Chang X, Lu DS. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol. 2008;19:1087–92.

    Article  PubMed  Google Scholar 

  45. Ahmad F, Gravante G, Bhardwaj N, Strickland A, Basit R, West K, et al. Large volume hepatic microwave ablation elicits fewer pulmonary changes than radiofrequency or cryotherapy. J Gastrointest Surg. 2010;14:1963–8.

    Article  PubMed  Google Scholar 

  46. Ahmad F, Gravante G, Bhardwaj N, Strickland A, Basit R, West K, et al. Renal effects of microwave ablation compared with radiofrequency, cryotherapy and surgical resection at different volumes of the liver treated. Liver Int. 2010;30:1305–14.

    Article  PubMed  Google Scholar 

  47. Skonieczki BD, Wells C, Wasser EJ, Dupuy DE. Radiofrequency and microwave tumor ablation in patients with implanted cardiac devices: is it safe? Eur J Radiol. 2011;79:343–6.

    Article  PubMed  Google Scholar 

  48. Andreano A, Huang Y, Meloni MF, Lee FT Jr, Brace C. Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue. Med Phys. 2010;37:2967–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Simon CJ, Dupuy DE, Iannitti DA, Lu DS, Yu NC, Aswad BI, et al. Intraoperative triple antenna hepatic microwave ablation. AJR Am J Roentgenol. 2006;187:W333–40.

    Article  PubMed  Google Scholar 

  50. Garrean S, Hering J, Saied A, Helton WS, Espat NJ. Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature. Am J Surg. 2008;195:508–20.

    Article  PubMed  Google Scholar 

  51. Garrean S, Hering J, Saied A, Hoopes PJ, Helton WS, Ryan TP, et al. Ultrasound monitoring of a novel microwave ablation (MWA) device in porcine liver: lessons learned and phenomena observed on ablative effects near major intrahepatic vessels. J Gastrointest Surg. 2009;13:334–40.

    Article  CAS  PubMed  Google Scholar 

  52. Lorentzen T, Skjoldbye BO, Nolsoe CP. Microwave ablation of liver metastases guided by contrast-enhanced ultrasound: experience with 125 metastases in 39 patients. Ultraschall Med. 2011;32:492–6.

    Article  CAS  PubMed  Google Scholar 

  53. Minami Y, Kudo M. Review of dynamic contrast-enhanced ultrasound guidance in ablation therapy for hepatocellular carcinoma. World J Gastroenterol. 2011;17:4952–9.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Byrd JF, Agee N, McKillop IH, Sindram D, Martinie JB, Iannitti DA. Colour doppler ultrasonography provides real-time microwave field visualisation in an ex vivo porcine model. HPB (Oxford). 2011;13:400–3.

    Article  Google Scholar 

  55. Xu J, Jia ZZ, Song ZJ, Yang XD, Chen K, Liang P. Three-dimensional ultrasound image-guided robotic system for accurate microwave coagulation of malignant liver tumours. Int J Med Robot. 2010;6:256–68.

    Article  PubMed  Google Scholar 

  56. Elias D, Baton O, Sideris L, Matsuhisa T, Pocard M, Lasser P. Local recurrences after intraoperative radiofrequency ablation of liver metastases: a comparative study with anatomic and wedge resections. Ann Surg Oncol. 2004;11:500–5.

    Article  PubMed  Google Scholar 

  57. Adam R, Laurent A, Azoulay D, Castaing D, Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann Surg. 2000;232:777–85.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  58. Wagmam LD. Importance of Response to Neoadjuvant Therapy in Patients With Liver-Limited mCRC When the Intent Is Resection and/or Ablation. Clin Colorectal Cancer. 2013;12:223–32.

    Google Scholar 

  59. Mima K, Beppu T, Chikamoto A, Miyamoto Y, Nakagawa S, Kuroki H, et al. Hepatic resection combined with radiofrequency ablation for initially unresectable colorectal liver metastases after effective chemotherapy is a safe procedure with a low incidence of local recurrence. Int J Clin Oncol. 2013;18:847–55.

    Google Scholar 

  60. Liang P, Dong B, Yu X, Yang Y, Yu D, Su L, et al. Prognostic factors for percutaneous microwave coagulation therapy of hepatic metastases. AJR Am J Roentgenol. 2003;181:1319–25.

    Article  PubMed  Google Scholar 

  61. Zhang X, Chen B, Hu S, Wang L, Wang K, Wachtel MS, et al. Microwave ablation with cooled-tip electrode for liver cancer: an analysis of 160 cases. Hepatogastroenterology. 2008;55:2184–7.

    PubMed  Google Scholar 

  62. Ogata Y, Uchida S, Hisaka T, Horiuchi H, Mori S, Ishibashi N, et al. Intraoperative thermal ablation therapy for small colorectal metastases to the liver. Hepatogastroenterology. 2008;55:550–6.

    PubMed  Google Scholar 

  63. Liang P, Wang Y, Yu X, Dong B. Malignant liver tumors: treatment with percutaneous microwave ablation-complications among cohort of 1136 patients. Radiology. 2009;251:933–40.

    Article  PubMed  Google Scholar 

  64. Stattner S, Jones RP, Yip VS, Buchanan K, Poston GJ, Malik HZ, et al. Microwave ablation with or without resection for colorectal liver metastases. Eur J Surg Oncol. 2013;39:844–9.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Some of the data reported in this publication have been presented to the Annual Meeting of the Austrian Society of Surgery, held in Salzburg, Austria in June 2012, and the 32nd Congress of the European Society of Surgical Oncology, held in Valencia, Spain in September 2012.

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The authors have no conflicts of interest. No commercial or financial support was given.

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Correspondence to Stefan Stättner.

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S. Stättner and F. Primavesi contributed equally to this work.

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Stättner, S., Primavesi, F., Yip, V.S. et al. Evolution of surgical microwave ablation for the treatment of colorectal cancer liver metastasis: review of the literature and a single centre experience. Surg Today 45, 407–415 (2015). https://doi.org/10.1007/s00595-014-0879-3

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