Safety and efficacity of microwave ablation for colorectal metastases near a vascular vessel: short-terme result of a single institute

Abstract

Background: Microwave ablation(mwa) is gaining wide acceptance. Many centers consider it as the first-line treatment for tumors less than 3 cm. RF energy is less efficient in treating tissues in high perfusion areas. A prospective study was started at our Institute to evaluate the safety and efficacy of mwa for colorectal liver metastasis(CLM)located near large vessels. Methods: Between March 2015 and Septemeber 2016, 44 patients underwent intraoperative mwa for liver tumors. Among them, 32 patients were treated for CLM. Twenty-one patients had CLM smaller than 3 cm and located near large vessels. Liver laboratory tests and postoperative morbidity were evaluated. The results of postoperative CT scans were checked for signs of local recurrence. Results: Surgery was performed by laparoscopy in 7 patients, by laparotomy in 13 patients and by thoracotomy in one case with CLM in segment VIII. Thirteen patients had associated mwa with minor liver resections, 4 patients had associated colorectal resections and only 4 patients had only mwa.Four patients were treated for local recurrence within a previous wedge resection or RFA. Overall morbidity rate was 19% with 4 minor complications. In the group of patients treated only with mwa, 1 case of liver hematoma occurred. The median follow-up was 6 months(4-17 months) and all patients are local recurrence-free. Conclusion: The present study suggests that the mwa near large vessels is a safe and effective method in short term basis. Still, long term outcomes have to be assessed.