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Microwave ablation combined with lipiodol-microsphere mixed or conventional transarterial chemoembolization for the treatment of colorectal liver metastases: A retrospective study - 20/08/22

Doi : 10.1016/j.clinre.2022.101986 
Qin Shi a, b, c, #, Feihang Wang a, b, c, #, Nan Du a, b, c, Yongjie Zhou a, b, c, Xin Zhou a, b, c, Jingqin Ma a, b, c, Minjie Yang a, b, c, Zihan Zhang a, b, c, Jiaze Yu a, b, c, Wen Zhang a, b, c, Jianjun Luo a, b, c, Lingxiao Liu a, b, c, , Zhiping Yan a, b, c,
a Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China 
b Shanghai Institution of Medical Imaging, Shanghai 200032, China 
c National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China 

Corresponding authors.

Highlights

We proposed a novel treatment scheme of lipiodol-microsphere mixed transarterial chemoembolization (mTACE) combined with microwave ablation (MWA) for colorectal liver metastases (CRLM) in this study.
Patients with CRLM who underwent MWA-mTACE had better local tumor control and improved progression-free survival than those who underwent MWA-cTACE.
Univariate and multivariate analyses indicated that, MWA-mTACE was an independent positive factor for progression-free survival, and abnormal carcinoembryonic antigen level was a hazard factor for overall survival.
mTACE combined with MWA might be a hopeful combination therapy for patients with CRLM.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Purpose

To investigate the clinical outcomes of microwave ablation (MWA) combined with lipiodol-microsphere mixed transarterial chemoembolization (mTACE) or conventional TACE (cTACE) for patients with colorectal liver metastases (CRLM).

Materials and Methods

This retrospective study evaluated the medical records of patients with CRLM who underwent MWA combined with mTACE or cTACE from January 2018 to September 2021. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were evaluated during the follow-up. In addition, prognostic factors affecting survival were analyzed by univariate and multivariate methods.

Results

A total of 79 patients with CRLM were enrolled in the study (MWA-mTACE group, n = 38; MWA-cTACE group, n = 41). The patients who underwent MWA-mTACE had higher DCR (86.8% vs. 65.9%, P = 0.029) and better PFS (median, 8.1 vs. 5.5 months, P = 0.018) than those who underwent MWA-cTACE, but no significant difference was found in ORR (34.2% vs. 22.0%, P = 0.225) and OS (median, 15.7 vs. 13.0 months, P = 0.231). Further univariate and multivariate analyses indicated that MWA-mTACE was an independent positive factor for PFS, and abnormal carcinoembryonic antigen level was a hazard factor for OS. The postoperative laboratory tests and complications in patients who underwent MWA-mTACE were similar to those who underwent MWA-cTACE.

Conclusion

Lipiodol-microsphere mixed TACE might be an effective and safe treatment to combine with microwave ablation for patients with colorectal liver metastases.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Colorectal liver metastases, Microwave ablation, Lipiodol-microsphere mixed transarterial chemoembolization, Survival


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Vol 46 - N° 7

Articolo 101986- Agosto 2022 Ritorno al numero
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