Abstract
BackgroundThermoablation is used to treat patients with unresectable colorectal liver metastases (CRLM). We analyze clinical outcome, proteome kinetics and angiogenic markers in patients treated by cryosurgical ablation (CSA) or radiofrequency ablation (RFA).Methods205 patients underwent CSA (n = 20), RFA (n = 22), partial hepatectomy (PH, n = 134) or were found truly unresectable (n = 29). Clinical outcome, proteome transitions and angiogenic response in serum were analyzed at various time points after ablation.ResultMedian overall survival in CSA patients (17.6 months) was worse (p < 0.0001) when compared to RFA treated patients (51.7 months) and patients after PH (43.4 months). The complication rate was higher in the CSA group (50%) as compared to the RFA group (22%). Proteomics analyses showed consistently more changes in serum protein abundance with CSA compared to RFA. In the first four days after ablation a pro-angiogenic serum response occurred.ConclusionsRFA of CRLM is superior to CSA with a median survival which equals survival in patients after PH. Proteomics analyses suggests a more aggravated serum response to CSA compared to RFA. Thermoablation is associated with changes in serum levels of angiogenic factors favouring a pro-angiogenic environment, but without differences between RFA and CSA.
Highlights
Thermoablation is used to treat patients with unresectable colorectal liver metastases (CRLM)
Proteomics analyses suggests a more aggravated serum response to cryosurgical ablation (CSA) compared to radiofrequency ablation (RFA)
Thermoablation is associated with changes in serum levels of angiogenic factors favouring a pro-angiogenic environment, but without differences between RFA and CSA
Summary
Thermoablation is used to treat patients with unresectable colorectal liver metastases (CRLM). The poor prognosis of patients with unresectable CRLM resulted in the application of thermoablation either by cryosurgical ablation (CSA) or radiofrequency ablation (RFA). In general one can conclude from the literature that the complication rate of CSA is higher than RFA [11,12]. This seems to be related to the systemic inflammatory response which is associated with CSA [13,14,15]. A recent review summarized the relation between inflammation, angiogenesis and tumor progression and the possible impact that RFA of liver tumors could have [22]
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