Systematic review of thermal ablation techniques for resectable colorectal liver metastases

Abstract

Background: Thermal ablation techniques (TAT) have shown positive but heterogenous outcomes in the treatment of CRLM. The aim of this systematic review is to evaluate complication and survival of TAT when treating resectable CRLM. Material and Methods: In accordance with the PRISMA guidelines, we searched the Medline, EMBASE, Cochrane and Web of Science databases for reports published before December 2019. We included papers assessing radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation (CA) and electroporation (IRE) treating CRLM curative intention. We analysed the rates of complications, mortality, local tumour progression (LTP), disease-free survival (DFS) and overall survival (OS). Results: The literature search yielded 6767 records, of which 20 papers (860 patients) met the inclusion criteria. None of studies related mortality with TAT. The median percentage of adverse events was 7% (0–25%): 8% with RFA (0–25%), 7% with MWA (7–14%). The median 3y DFS rate was 32% (15–70%): 24% with RFA (15–58%), 60% with MWA (50–70%); the median 5y DFS rate was 27% (5–39%): 18% with RFA (12–41%), 38.5% with MWA (38–39%). The median 3y OS rate was 59% (14–91%): 60% with RFA (38–91%), 70% with MWA (14–70%), 34% with CA (31–37%); the median 5y OS rate was 44.5% (14–58%): 43% with RFA (14–56%), 55% with MWA (52–58%). Conclusions: MWA shows a similar rate of adverse events to other types of TAT with lower rates of LTP and improved DFS and OS rates.