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Review
. 2022 Mar 3;14(5):1305.
doi: 10.3390/cancers14051305.

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Antonio Mimmo  1 , Francesca Pegoraro  1   2 , Rami Rhaiem  1 , Roberto Montalti  2 , Alix Donadieu  1 , Ahmad Tashkandi  1 , Abdul Rahman Al-Sadairi  1 , Reza Kianmanesh  1 , Tullio Piardi  3
Affiliations
Review

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Antonio Mimmo et al. Cancers (Basel). .

Abstract

(1) Background: colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancer; however, few patients are fit for curative surgery. Microwave ablation (MWA) showed promising outcomes in this cohort of patients. This systematic review and pooled analysis aimed to analyze the oncological results of MWA for CRLM. (2) Methods: Following PRISMA guidelines, PubMed, Scopus, EMBASE, Google Scholar, Science Direct, and the Wiley Online Library databases were searched for reports published before January 2021. We included papers assessing MWA, treating resectable CRLM with curative intention. We evaluated the reported MWA-related complications and oncological outcomes as being recurrence-free (RF), free from local recurrence (FFLR), and overall survival rates (OS). (3) Results: Twelve out of 4822 papers (395 patients) were finally included. Global RF rates at 1, 3, and 5 years were 65.1%, 44.6%, and 34.3%, respectively. Global FFLR rates at 3, 6, and 12 months were 96.3%, 89.6%, and 83.7%, respectively. Global OS at 1, 3, and 5 years were 86.7%, 59.6%, and 44.8%, respectively. A better FFLR was reached using the MWA surgical approach at 3, 6, and 12 months, with reported rates of 97.1%, 92.7%, and 88.6%, respectively. (4) Conclusions: Surgical MWA treatment for CRLM smaller than 3 cm is a safe and valid option. This approach can be safely included for selected patients in the curative intent approaches to treating CRLM.

Keywords: colorectal liver metastasis; liver resection; microwave ablation.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Flowchart showing the selection process of the included studies. Abbreviations: colorectal liver metastases (CRLM), microwave ablation (MWA).
Figure 2
Figure 2
(a) Sub-analysis on studies comprising lesions <30 mm only: Recurrence Free Survival data. In dotted lines are indicated the 95% confidence intervals, (b) Sub-analysis on studies comprising lesions <30 mm only: Free from Local Recurrence outcome. In dotted lines are indicated the 95% confidence intervals.
Figure 3
Figure 3
(a) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Recurrence Free Survival outcomes. In dotted lines are indicated the 95% confidence intervals, (b) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Free from Local Recurrence outcomes. In dotted lines are indicated the 95% confidence intervals, (c) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Overall Survival outcomes. In dotted lines are indicated the 95% confidence intervals.
Figure 3
Figure 3
(a) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Recurrence Free Survival outcomes. In dotted lines are indicated the 95% confidence intervals, (b) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Free from Local Recurrence outcomes. In dotted lines are indicated the 95% confidence intervals, (c) Sub-analysis on studies comprising surgical vs. radiological approach, concerning Overall Survival outcomes. In dotted lines are indicated the 95% confidence intervals.
Figure 4
Figure 4
Sub-analysis on studies comprising lesions treated by open vs. laparoscopic surgical approach, concerning Overall Survival outcomes. In dotted lines are indicated the 95% confidence intervals.
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