Synapse - Biopsy and margins optimize outcomes after thermal ablation of colorectal liver metastases

Biopsy and margins optimize outcomes after thermal ablation of colorectal liver metastases Journal Article

Authors:	Vasiniotis Kamarinos, N.; Vakiani, E.; Gonen, M.; Kemeny, N. E.; Sigel, C.; Saltz, L. B.; Brown, K. T.; Covey, A. M.; Erinjeri, J. P.; Brody, L. A.; Ziv, E.; Yarmohammadi, H.; Kunin, H.; Barlas, A.; Petre, E. N.; Kingham, P. T.; D’Angelica, M. I.; Manova-Todorova, K.; Solomon, S. B.; Sofocleous, C. T.
Article Title:	Biopsy and margins optimize outcomes after thermal ablation of colorectal liver metastases
Abstract:	Background: Thermal ablation is a definitive local treatment for selected colorectal liver metastases (CLM) that can be ablated with adequate margins. A critical limitation has been local tumor progression (LTP). Methods: This prospective, single-group, phase 2 study enrolled patients with CLM < 5 cm in maximum diameter, at a tertiary cancer center between November 2009 and February 2019. Biopsy of the ablation zone center and margin was performed immediately after ablation. Viable tumor in tissue biopsy and ablation margins < 5 mm were assessed as predictors of 12-month LTP. Results: We enrolled 107 patients with 182 CLMs. Mean tumor size was 2.0 (range, 0.6–4.6) cm. Microwave ablation was used in 51% and radiofrequency ablation in 49% of tumors. The 12-and 24-month cumulative incidence of LTP was 22% (95% confidence interval [CI]: 17, 29) and 29% (95% CI: 23, 36), respectively. LTP at 12 months was 7% (95% CI: 3, 14) for the biopsy tumor-negative ablation zone with margins ≥ 5 mm vs. 63% (95% CI: 35, 85) for the biopsy-positive ablation zone with margins < 5 mm (p < 0.001). Conclusions: Biopsy-proven complete tumor ablation with margins of at least 5 mm achieves optimal local tumor control for CLM, regardless of the ablation modality used. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords:	colorectal liver metastases; thermal ablation; ablation margin assessment; post-ablation biopsy
Journal Title:	Cancers
Volume:	14
Issue:	3
ISSN:	2072-6694
Publisher:	MDPI
Date Published:	2022-02-01
Start Page:	693
Language:	English
DOI:	10.3390/cancers14030693
PROVIDER:	scopus
PMCID:	PMC8833800
PUBMED:	35158963
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85123691901&doi=10.3390%2fcancers14030693&partnerID=40&md5=385ee4d4c689e170902cc4f3fb6c5c68
Notes:	Article -- Export Date: 1 March 2022 -- Source: Scopus