International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group | 2021
MRI-guided percutaneous thermoablation as first-line treatment of recurrent hepatic malignancies following hepatic resection: single center long-term experience.
Abstract
PURPOSE\nHepatic recurrence of liver malignancies is a leading problem in patients after liver resection with curative intention. Thermoablation is a promising treatment approach for patients after hepatic resection, especially in liver-limited conditions. This study aimed to investigate safety, survival, and local tumor control rates of MRI-guided percutaneous thermoablation of recurrent hepatic malignancies following hepatic resection.\n\n\nMATERIAL AND METHODS\nData from patients with primary or secondary hepatic malignancies treated between 2004 and 2018 with MRI-guided percutaneous thermoablation of hepatic recurrence after prior hepatic resection were retrospectively analyzed. Disease-free survival and overall survival rates were calculated using the Kaplan-Meier method.\n\n\nRESULTS\nA total of 57 patients with hepatic recurrence (mean tumor size = 18.9\u2009±\u20099.1\u2009mm) of colorectal cancer liver metastases (n\u2009=\u200927), hepatocellular carcinoma (n\u2009=\u200917), intrahepatic recurrence of cholangiocellular carcinoma (n\u2009=\u20099), or other primary malignant tumor entities (n\u2009=\u20094) were treated once or several times with MR-guided percutaneous radiofrequency (n\u2009=\u200952) or microwave ablation (n\u2009=\u20095) (range: 1-4 times). Disease progression occurred due to local recurrence at the ablation site in nine patients (15.8%), non-local hepatic recurrence in 33 patients (57.9%), and distant malignancy in 18 patients (31.6%). The median overall survival for the total cohort was 40\u2009months and 49\u2009months for the colorectal cancer group, with a 5-year overall survival rate of 40.7 and 42.5%, respectively. The median disease-free survival was 10\u2009months for both the total cohort and the colorectal cancer group with a 5-year disease-free survival rate of 15.1 and 14.8%, respectively. The mean follow-up time was 39.6\u2009±\u200935.7\u2009months.\n\n\nCONCLUSION\nMR-guided thermoablation is an effective and safe approach in the treatment of hepatic recurrences in liver-limited conditions and can achieve long-term survival.