Waleed Shady1, Elena N Petre1, Kinh Gian Do2, Mithat Gonen3, Hooman Yarmohammadi1, Karen T Brown1, Nancy E Kemeny4, Michael D'Angelica5, Peter T Kingham5, Stephen B Solomon1, Constantinos T Sofocleous6. 1. Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. 2. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. 3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. 4. Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. 5. Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. 6. Section of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065. Electronic address: sofoclec@mskcc.org.
Abstract
PURPOSE: To identify and compare predictors of local tumor progression (LTP)-free survival (LTPFS) after radiofrequency (RF) ablation and microwave (MW) ablation of colorectal liver metastases (CLMs). MATERIALS AND METHODS: This is a retrospective review of CLMs ablated from November 2009 to April 2015 (110 patients). Margins were measured on contrast-enhanced computed tomography (CT) 6 weeks after ablation. Clinical and technical predictors of LTPFS were assessed using a competing risk model adjusted for clustering. RESULTS: Technique effectiveness (complete ablation) was 93% (79/85) for RF ablation and 97% (58/60) for MW ablation (P = .47). The median follow-up period was significantly longer for RF ablation than for MW ablation (56 months vs. 29 months) (P < .001). There was no difference in the local tumor progression (LTP) rates between RF ablation and MW ablation (P = 0.84). Significant predictors of shorter LTPFS for RF ablation on univariate analysis were ablation margins 5 mm or smaller (P < .001) (hazard ratio [HR]: 14.6; 95% confidence interval [CI]: 5.2-40.9) and perivascular tumors (P = .021) (HR: 2.2; 95% CI: 1.1-4.3); both retained significance on multivariate analysis. Significant predictors of shorter LTPFS on univariate analysis for MW ablation were ablation margins 5 mm or smaller (P < .001) (subhazard ratio: 11.6; 95% CI: 3.1-42.7) and no history of prior liver resection (P < .013) (HR: 3.2; 95%: 1.3-7.8); both retained significance on multivariate analysis. There was no LTP for tumors ablated with margins over 10 mm (median LTPFS: not reached). Perivascular tumors were not predictive for MW ablation (P = .43). CONCLUSIONS: Regardless of the thermal ablation modality used, margins larger than 5 mm are critical for local tumor control, with no LTP noted for margins over 10 mm. Unlike RF ablation, the efficiency of MW ablation was not affected for perivascular tumors.
PURPOSE: To identify and compare predictors of local tumor progression (LTP)-free survival (LTPFS) after radiofrequency (RF) ablation and microwave (MW) ablation of colorectal liver metastases (CLMs). MATERIALS AND METHODS: This is a retrospective review of CLMs ablated from November 2009 to April 2015 (110 patients). Margins were measured on contrast-enhanced computed tomography (CT) 6 weeks after ablation. Clinical and technical predictors of LTPFS were assessed using a competing risk model adjusted for clustering. RESULTS: Technique effectiveness (complete ablation) was 93% (79/85) for RF ablation and 97% (58/60) for MW ablation (P = .47). The median follow-up period was significantly longer for RF ablation than for MW ablation (56 months vs. 29 months) (P < .001). There was no difference in the local tumor progression (LTP) rates between RF ablation and MW ablation (P = 0.84). Significant predictors of shorter LTPFS for RF ablation on univariate analysis were ablation margins 5 mm or smaller (P < .001) (hazard ratio [HR]: 14.6; 95% confidence interval [CI]: 5.2-40.9) and perivascular tumors (P = .021) (HR: 2.2; 95% CI: 1.1-4.3); both retained significance on multivariate analysis. Significant predictors of shorter LTPFS on univariate analysis for MW ablation were ablation margins 5 mm or smaller (P < .001) (subhazard ratio: 11.6; 95% CI: 3.1-42.7) and no history of prior liver resection (P < .013) (HR: 3.2; 95%: 1.3-7.8); both retained significance on multivariate analysis. There was no LTP for tumors ablated with margins over 10 mm (median LTPFS: not reached). Perivascular tumors were not predictive for MW ablation (P = .43). CONCLUSIONS: Regardless of the thermal ablation modality used, margins larger than 5 mm are critical for local tumor control, with no LTP noted for margins over 10 mm. Unlike RF ablation, the efficiency of MW ablation was not affected for perivascular tumors.
Authors: Etay Ziv; Joseph P Erinjeri; Hooman Yarmohammadi; F Edward Boas; Elena N Petre; Song Gao; Waleed Shady; Constantinos T Sofocleous; David R Jones; Charles M Rudin; Stephen B Solomon Journal: Radiology Date: 2016-07-19 Impact factor: 11.105
Authors: Tito Livraghi; Luigi Solbiati; M Franca Meloni; G Scott Gazelle; Elkan F Halpern; S Nahum Goldberg Journal: Radiology Date: 2003-02 Impact factor: 11.105
Authors: Kristina I Ringe; Carolin Lutat; Christian Rieder; Andrea Schenk; Frank Wacker; Hans-Juergen Raatschen Journal: PLoS One Date: 2015-07-29 Impact factor: 3.240
Authors: Elena A Kaye; Francois H Cornelis; Elena N Petre; Neelam Tyagi; Waleed Shady; Weiji Shi; Zhigang Zhang; Stephen B Solomon; Constantinos T Sofocleous; Jeremy C Durack Journal: Eur Radiol Date: 2018-11-06 Impact factor: 5.315
Authors: Vlasios S Sotirchos; Sho Fujisawa; Efsevia Vakiani; Stephen B Solomon; Katia O Manova-Todorova; Constantinos T Sofocleous Journal: Ann Surg Oncol Date: 2019-03-04 Impact factor: 5.344
Authors: Francois H Cornelis; Elena N Petre; Efsevia Vakiani; David Klimstra; Jeremy C Durack; Mithat Gonen; Joseph Osborne; Stephen B Solomon; Constantinos T Sofocleous Journal: J Nucl Med Date: 2018-02-09 Impact factor: 10.057
Authors: R Vera; E González-Flores; C Rubio; J Urbano; M Valero Camps; J J Ciampi-Dopazo; J Orcajo Rincón; V Morillo Macías; M A Gomez Braco; G Suarez-Artacho Journal: Clin Transl Oncol Date: 2019-07-29 Impact factor: 3.405
Authors: Timothy J Ziemlewicz; J Louis Hinshaw; Meghan G Lubner; Emily A Knott; Bridgett J Willey; Fred T Lee; Christopher L Brace Journal: Int J Hyperthermia Date: 2020 Impact factor: 3.914