Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

Alice Gillams, Nahum Goldberg, Muneeb Ahmed, Reto Bale, David Breen, Matthew Callstrom, Min Hua Chen, Byung Ihn Choi, Thierry de Baere, Damian Dupuy, Afshin Gangi, Debra Gervais, Thomas Helmberger, Ernst Michael Jung, Fred Lee, Riccardo Lencioni, Ping Liang, Tito Livraghi, David Lu, Franca MeloniPhilippe Pereira, Fabio Piscaglia, Hyunchul Rhim, Riad Salem, Constantinos Sofocleous, Stephen B. Solomon, Michael Soulen, Masatoshi Tanaka, Thomas Vogl, Brad Wood, Luigi Solbiati

Research output: Contribution to journalArticle

122 Scopus citations

Abstract

Objectives: Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases. Methods: This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented. Results: Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable. Conclusions: In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology. Key Points: • Best results require due consideration of tumour size, number, volume and location. • Ablation technology, imaging guidance and intra-procedural imaging assessment must be optimised. • Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve. • Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach. • Future applications may include resectable disease, e.g. for small solitary tumours.

Original languageEnglish (US)
Pages (from-to)3438-3454
Number of pages17
JournalEuropean radiology
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2015

Keywords

  • Ablation techniques
  • Clinical protocols
  • Colorectal neoplasms
  • Consensus
  • Liver neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Gillams, A., Goldberg, N., Ahmed, M., Bale, R., Breen, D., Callstrom, M., Chen, M. H., Choi, B. I., de Baere, T., Dupuy, D., Gangi, A., Gervais, D., Helmberger, T., Jung, E. M., Lee, F., Lencioni, R., Liang, P., Livraghi, T., Lu, D., ... Solbiati, L. (2015). Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013. European radiology, 25(12), 3438-3454. https://doi.org/10.1007/s00330-015-3779-z