Mimmo Antonio, Pegoraro Francesca, Rhaiem Rami, Montalti Roberto, Donadieu Alix, Tashkandi Ahmad, Al-Sadairi Abdul Rahman, Kianmanesh Reza, Piardi Tullio
Department of Hepatobiliary, Pancreatic and Digestive Oncological Surgery, Reims Medical Faculty, Robert Debré University Hospital, University of Reims Champagne-Ardenne, Rue du Général Koenig, 51100 Reims, France.
Division of Hepato-Bilio-Pancreatic, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy.
Cancers (Basel). 2022 Mar 3;14(5):1305. doi: 10.3390/cancers14051305.
(1) Background: colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancer; however, few patients are fit for curative surgery. Microwave ablation (MWA) showed promising outcomes in this cohort of patients. This systematic review and pooled analysis aimed to analyze the oncological results of MWA for CRLM. (2) Methods: Following PRISMA guidelines, PubMed, Scopus, EMBASE, Google Scholar, Science Direct, and the Wiley Online Library databases were searched for reports published before January 2021. We included papers assessing MWA, treating resectable CRLM with curative intention. We evaluated the reported MWA-related complications and oncological outcomes as being recurrence-free (RF), free from local recurrence (FFLR), and overall survival rates (OS). (3) Results: Twelve out of 4822 papers (395 patients) were finally included. Global RF rates at 1, 3, and 5 years were 65.1%, 44.6%, and 34.3%, respectively. Global FFLR rates at 3, 6, and 12 months were 96.3%, 89.6%, and 83.7%, respectively. Global OS at 1, 3, and 5 years were 86.7%, 59.6%, and 44.8%, respectively. A better FFLR was reached using the MWA surgical approach at 3, 6, and 12 months, with reported rates of 97.1%, 92.7%, and 88.6%, respectively. (4) Conclusions: Surgical MWA treatment for CRLM smaller than 3 cm is a safe and valid option. This approach can be safely included for selected patients in the curative intent approaches to treating CRLM.
(1) 背景:结直肠癌肝转移(CRLM)是结直肠癌最常见的非淋巴转移;然而,适合进行根治性手术的患者很少。微波消融(MWA)在这类患者中显示出了有前景的结果。本系统评价和汇总分析旨在分析MWA治疗CRLM的肿瘤学结果。(2) 方法:按照PRISMA指南,检索了PubMed、Scopus、EMBASE、谷歌学术、科学Direct和Wiley在线图书馆数据库中2021年1月之前发表的报告。我们纳入了评估MWA、以根治为目的治疗可切除CRLM的论文。我们将报告的与MWA相关的并发症以及肿瘤学结果评估为无复发生存率(RF)、无局部复发生存率(FFLR)和总生存率(OS)。(3) 结果:最终纳入了4822篇论文中的12篇(395例患者)。1年、3年和5年的总体RF率分别为65.1%、44.6%和34.3%。3个月、6个月和12个月的总体FFLR率分别为96.3%、89.6%和83.7%。1年、3年和5年的总体OS分别为86.7%·、59.6%和44.8%。采用MWA手术方法在3个月、6个月和12个月时达到了更好的FFLR,报告的比率分别为97.1%、92.7%和88.6%。(4) 结论:手术MWA治疗直径小于3 cm的CRLM是一种安全有效的选择。对于选定的患者,这种方法可以安全地纳入以根治为目的治疗CRLM的方法中。