Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study
The aim of this study was to assess safety, efficacy and survival outcomes of repeat thermal ablation as compared to repeat partial hepatectomy in patients with recurrent colorectal liver metastases (CRLM). This Amsterdam Colorectal Liver Met Registry (AmCORE) based study of two cohorts, repeat ther...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/11/2769 |
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| author | Madelon Dijkstra Sanne Nieuwenhuizen Robbert S. Puijk Florentine E.F. Timmer Bart Geboers Evelien A.C. Schouten Jip Opperman Hester J. Scheffer Jan J.J. de Vries Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Martijn R. Meijerink |
| author_facet | Madelon Dijkstra Sanne Nieuwenhuizen Robbert S. Puijk Florentine E.F. Timmer Bart Geboers Evelien A.C. Schouten Jip Opperman Hester J. Scheffer Jan J.J. de Vries Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Martijn R. Meijerink |
| author_sort | Madelon Dijkstra |
| collection | DOAJ |
| description | The aim of this study was to assess safety, efficacy and survival outcomes of repeat thermal ablation as compared to repeat partial hepatectomy in patients with recurrent colorectal liver metastases (CRLM). This Amsterdam Colorectal Liver Met Registry (AmCORE) based study of two cohorts, repeat thermal ablation versus repeat partial hepatectomy, analyzed 136 patients (100 thermal ablation, 36 partial hepatectomy) and 224 tumors (170 thermal ablation, 54 partial hepatectomy) with recurrent CRLM from May 2002 to December 2020. The primary and secondary endpoints were overall survival (OS), distant progression-free survival (DPFS) and local tumor progression-free survival (LTPFS), estimated using the Kaplan–Meier method, and complications, analyzed using the chi-square test. Multivariable analyses based on Cox proportional hazards model were used to account for potential confounders. In addition, subgroup analyses according to patient, initial and repeat local treatment characteristics were performed. In the crude overall comparison, OS of patients treated with repeat partial hepatectomy was not statistically different from repeat thermal ablation (<i>p</i> = 0.927). Further quantification of OS, after accounting for potential confounders, demonstrated concordant results for repeat local treatment (hazard ratio (HR), 0.986; 95% confidence interval (CI), 0.517–1.881; <i>p</i> = 0.966). The 1-, 3- and 5-year OS were 98.9%, 62.6% and 42.3% respectively for the thermal ablation group and 93.8%, 74.5% and 49.3% for the repeat resection group. No differences in DPFS (<i>p</i> = 0.942), LTPFS (<i>p</i> = 0.397) and complication rate (<i>p</i> = 0.063) were found. Mean length of hospital stay was 2.1 days in the repeat thermal ablation group and 4.8 days in the repeat partial hepatectomy group (<i>p</i> = 0.009). Subgroup analyses identified no heterogeneous treatment effects according to patient, initial and repeat local treatment characteristics. Repeat partial hepatectomy was not statistically different from repeat thermal ablation with regard to OS, DPFS, LTPFS and complications, whereas length of hospital stay favored repeat thermal ablation. Thermal ablation should be considered a valid and potentially less invasive alternative for small-size (0–3 cm) CRLM in the treatment of recurrent new CRLM. While, the eagerly awaited results of the phase III prospective randomized controlled COLLISION trial (NCT03088150) should provide definitive answers regarding surgery versus thermal ablation for CRLM. |
| first_indexed | 2024-03-10T10:47:09Z |
| format | Article |
| id | doaj.art-bccb0e4648444583ae29b7f6975c380e |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T10:47:09Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-bccb0e4648444583ae29b7f6975c380e2023-11-21T22:33:57ZengMDPI AGCancers2072-66942021-06-011311276910.3390/cancers13112769Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based StudyMadelon Dijkstra0Sanne Nieuwenhuizen1Robbert S. Puijk2Florentine E.F. Timmer3Bart Geboers4Evelien A.C. Schouten5Jip Opperman6Hester J. Scheffer7Jan J.J. de Vries8Rutger-Jan Swijnenburg9Kathelijn S. Versteeg10Birgit I. Lissenberg-Witte11M. Petrousjka van den Tol12Martijn R. Meijerink13Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Noordwest Ziekenhuisgroep, location Alkmaar, 1800 AM Alkmaar, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Surgery, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Medical Oncology, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Epidemiology and Data Science, Amsterdam University Medical Centers VU Medical Center Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Surgery, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU Medical Center Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The NetherlandsThe aim of this study was to assess safety, efficacy and survival outcomes of repeat thermal ablation as compared to repeat partial hepatectomy in patients with recurrent colorectal liver metastases (CRLM). This Amsterdam Colorectal Liver Met Registry (AmCORE) based study of two cohorts, repeat thermal ablation versus repeat partial hepatectomy, analyzed 136 patients (100 thermal ablation, 36 partial hepatectomy) and 224 tumors (170 thermal ablation, 54 partial hepatectomy) with recurrent CRLM from May 2002 to December 2020. The primary and secondary endpoints were overall survival (OS), distant progression-free survival (DPFS) and local tumor progression-free survival (LTPFS), estimated using the Kaplan–Meier method, and complications, analyzed using the chi-square test. Multivariable analyses based on Cox proportional hazards model were used to account for potential confounders. In addition, subgroup analyses according to patient, initial and repeat local treatment characteristics were performed. In the crude overall comparison, OS of patients treated with repeat partial hepatectomy was not statistically different from repeat thermal ablation (<i>p</i> = 0.927). Further quantification of OS, after accounting for potential confounders, demonstrated concordant results for repeat local treatment (hazard ratio (HR), 0.986; 95% confidence interval (CI), 0.517–1.881; <i>p</i> = 0.966). The 1-, 3- and 5-year OS were 98.9%, 62.6% and 42.3% respectively for the thermal ablation group and 93.8%, 74.5% and 49.3% for the repeat resection group. No differences in DPFS (<i>p</i> = 0.942), LTPFS (<i>p</i> = 0.397) and complication rate (<i>p</i> = 0.063) were found. Mean length of hospital stay was 2.1 days in the repeat thermal ablation group and 4.8 days in the repeat partial hepatectomy group (<i>p</i> = 0.009). Subgroup analyses identified no heterogeneous treatment effects according to patient, initial and repeat local treatment characteristics. Repeat partial hepatectomy was not statistically different from repeat thermal ablation with regard to OS, DPFS, LTPFS and complications, whereas length of hospital stay favored repeat thermal ablation. Thermal ablation should be considered a valid and potentially less invasive alternative for small-size (0–3 cm) CRLM in the treatment of recurrent new CRLM. While, the eagerly awaited results of the phase III prospective randomized controlled COLLISION trial (NCT03088150) should provide definitive answers regarding surgery versus thermal ablation for CRLM.https://www.mdpi.com/2072-6694/13/11/2769colorectal liver metastases (CRLM)recurrencethermal ablationpartial hepatectomy (PH)microwave ablation (MWA)radiofrequency ablation (RFA) |
| spellingShingle | Madelon Dijkstra Sanne Nieuwenhuizen Robbert S. Puijk Florentine E.F. Timmer Bart Geboers Evelien A.C. Schouten Jip Opperman Hester J. Scheffer Jan J.J. de Vries Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Martijn R. Meijerink Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study Cancers colorectal liver metastases (CRLM) recurrence thermal ablation partial hepatectomy (PH) microwave ablation (MWA) radiofrequency ablation (RFA) |
| title | Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study |
| title_full | Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study |
| title_fullStr | Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study |
| title_full_unstemmed | Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study |
| title_short | Thermal Ablation Compared to Partial Hepatectomy for Recurrent Colorectal Liver Metastases: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study |
| title_sort | thermal ablation compared to partial hepatectomy for recurrent colorectal liver metastases an amsterdam colorectal liver met registry amcore based study |
| topic | colorectal liver metastases (CRLM) recurrence thermal ablation partial hepatectomy (PH) microwave ablation (MWA) radiofrequency ablation (RFA) |
| url | https://www.mdpi.com/2072-6694/13/11/2769 |
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