Clinical progress of local treatment for unresectable colorectal liver metastases

Abstract

Abstract: Liver is the most common site of metastasis in colorectal cancer patients. With the development of systematic therapeutic drugs, the survival rate of patients with colorectal cancer liver metastases (CRLM) has been significantly improved. Systemic treatment combined with local treatment is the current treatment strategy that can control the disease for a long time and even cure CRLM. As a local treatment, thermal ablation or stereotactic radiotherapy (SRT) can be safely performed in patients with special metastatic lesions, elderly patients or patients with comorbidities. This article reviews the clinical application and research progress of thermal ablation and SRT in CRLM based on existing research evidence.

Key words: Colorectal cancer, Liver metastases, Microwave ablation, Radiofrequency ablation, Stereotactic radiotherapy

Lan Dongmei, Huang Xiaozhun, Ran Yihong, Xu Lin, Huang Zhangkan, Yin Xin, Che Xu, Bi Xinyu, Zhao Jianjun, Wang Shubin. Clinical progress of local treatment for unresectable colorectal liver metastases[J]. Electronic Journal of Liver Tumor, 2023, 10(1): 35-38.

References

[1] HESS K R, VARADHACHARY G R, TAYLOR S H, et al.Metastatic Patterns in Adenocarcinoma[J]. Cancer, 2006, 106(7): 1624-1633.
[2] EEGSTRAND J, NILSSON H, STRÖMBERG C, et al. Colorectal Cancer Liver Metastases-a Population-Based Study on Incidence, Management and Survival[J]. BMC Cancer, 2018, 18(1): 78.
[3] VERA R, GONZÁLEZ-FLORES E, RUBIO C, et al. Multidisciplinary Management of Liver Metastases in Patients with Colorectal Cancer: A Consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM[J]. Clin Transl Oncol, 2019, 22(5): 647-662.
[4] ELFRINK A K E, NIEUWENHUIZEN S, VAN DEN TOL M P, et al. Hospital Variation in Combined Liver Resection and Thermal Ablation for Colorectal Liver Metastases and Impact on Short-Term Postoperative Outcomes: A Nationwide Population-Based Study[J]. HPB, 2021, 23(6): 827-839.
[5] KIM K H, YOON Y S, YU C S, et al.Comparative Analysis of Radiofrequency Ablation and Surgical Resection for Colorectal Liver Metastases[J]. J Korean Surg Soc, 2011, 81(1): 25.
[6] EVRARD S, POSTON G, KISSMEYER-NIELSEN P, et al.Combined Ablation and Resection (CARe) as an Effective Parenchymal Sparing Treatment for Extensive Colorectal Liver Metastases[J]. PLoS ONE, 2014, 9(12): e114404.
[7] GILLAMS A, GOLDBERG N, AHMED M, et al.Thermal Ablation of Colorectal Liver Metastases: A Position Paper by an International Panel of Ablation Experts, the Interventional Oncology sans Frontières Meeting 2013[J]. Eur Radiol, 2015, 25(12): 3438-3454.
[8] MEIJERINK M R, PUIJK R S, VAN TILBORG A A J M, et al. Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis[J]. Cardiovasc Intervent Radiol, 2018, 41(8): 1189-1204.
[9] RUERS T, VAN COEVORDEN F, PUNT C J A, et al. Local Treatment of Unresectable Colorectal Liver Metastases: Results of a Randomized Phase Ⅱ Trial[J]. J Natl Cancer Inst, 2017, 109(9): djx015.
[10] VAN TILBORG A A J M, SCHEFFER H J, DE JONG M C, et al. MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts[J]. Cardiovasc Intervent Radiol, 2016, 39(10): 1438-1446.
[11] TANIS E, NORDLINGER B, MAUER M, et al.Local Recurrence Rates after Radiofrequency Ablation or Resection of Colorectal Liver Metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983[J]. Eur J Cancer, 2014, 50(5): 912-919.
[12] 黄小准, 黄璋侃, 周厚宏, 等. 热消融在肝脏恶性肿瘤的临床应用进展[J/CD]. 肝癌电子杂志, 2018, 5(4): 20-25.
[13] DI MARTINO M, ROMPIANESI G, MORA-GUZMÁN I, et al. Systematic Review and Meta-Analysis of Local Ablative Therapies for Resectable Colorectal Liver Metastases[J]. Eur J Surg Oncol, 2020, 46(5): 772-781.
[14] 李广涛, 朱晓琳, 何红莹, 等. 射频消融与手术切除治疗结直肠癌肝转移的疗效比较[J]. 中华肝胆外科杂志, 2019, 25(7): 487-492.
[15] GAVRIILIDIS P, ROBERTS K J, DE' ANGELIS N, et al. Recurrence and Survival Following Microwave, Radiofrequency Ablation, and Hepatic Resection of Colorectal Liver Metastases: A Systematic Review and Network Meta-Analysis[J]. Hepatobiliary Pancreat Dis Int, 2021, 20(4): 307-314.
[16] HUANG X, LIU Y, XU L, et al.Meta-Analysis of Percutaneous vs. Surgical Approaches Radiofrequency Ablation in Hepatocellular Carcinoma[J]. Front Surg, 2022, 8: 788771.
[17] HUO Y R, ESLICK G D. Microwave Ablation Compared to Radiofrequency Ablation for Hepatic Lesions: A Meta-Analysis[J]. J Vasc Interv Radiol, 2015, 26(8): 1139-1146.e2.
[18] LIU Y, LI S, WAN X, et al.Efficacy and Safety of Thermal Ablation in Patients with Liver Metastases[J]. Eur J Gastroenterol Hepatol, 2013, 25(4): 442-446.
[19] CORREA-GALLEGO C, FONG Y, GONEN M, et al.A Retrospective Comparison of Microwave Ablation vs. Radiofrequency Ablation for Colorectal Cancer Hepatic Metastases[J]. Ann Surg Oncol, 2014, 21(13): 4278-4283.
[20] LENCIONI R, CROCETTI L.Local-Regional Treatment of Hepatocellular Carcinoma[J]. Radiology, 2012, 262(1): 43-58.
[21] DIJKSTRA M, NIEUWENHUIZEN S, PUIJK R S, et al.Primary Tumor Sidedness, RAS and BRAF Mutations and MSI Status as Prognostic Factors in Patients with Colorectal Liver Metastases Treated with Surgery and Thermal Ablation: Results from the Amsterdam Colorectal Liver Met Registry (AmCORE)[J]. Biomedicines, 2021, 9(8): 962.
[22] ODISIO B C, YAMASHITA S, HUANG S Y, et al.Local Tumour Progression after Percutaneous Ablation of Colorectal Liver Metastases According to RAS Mutation Status[J]. Br J Surg, 2017, 104(6): 760-768.
[23] SHADY W, PRTRE E N, VAKIANI E, et al.Kras Mutation Is a Marker of Worse Oncologic Outcomes after Percutaneous Radiofrequency Ablation of Colorectal Liver Metastases[J]. Oncotarget, 2017, 8(39): 66117-66127.
[24] PENG J H, TAI Y, ZHAO Y X, et al.Programmed Death-Ligand 1 Expression in the Tumour Stroma of Colorectal Liver Oligometastases and Its Association with Prognosis after Liver Resection[J]. Gastroenterol Rep (Oxf), 2020, 9(5): 443-450.
[25] PRASANNAT T, WONG R, PRICE T, et al.Metastasectomy and BRAF Mutation; an Analysis of Survival Outcome in Metastatic Colorectal Cancer[J]. Curr Probl Cancer, 2021, 45(1): 100637.
[26] RUERS T, PUNT C, VAN COEVORDEN F, et al.Radiofrequency Ablation Combined with Systemic Treatment versus Systemic Treatment Alone in Patients with Non-Resectable Colorectal Liver Metastases: A Randomized EORTC Intergroup Phase Ⅱ Study (EORTC 40004)[J]. Ann Oncol, 2012, 23(10): 2619-2626.
[27] EVRARD S, RIVOIRE M, ARNAUD J, et al.Unresectable colorectal cancer liver metastases treated by intraoperative radiofrequency ablation with or without resection[J]. Br J Surg, 2012, 99(4): 558-565.
[28] MÉNDEZ ROMERO A, DE MAN R A. Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors: From Technological Evolution to Improved Patient Care[J]. Best Pract Res Clin Gastroenterol, 2016, 30(4): 603-616.
[29] SCORESTTI M, COMITO T, TOZZI A, et al.Final Results of a Phase Ⅱ Trial for Stereotactic Body Radiation Therapy for Patients with Inoperable Liver Metastases from Colorectal Cancer[J]. J Cancer Res Clin Oncol, 2014, 141(3): 543-553.
[30] SONG C W, GLATSTEIN E, MARKS L B, et al.Biological Principles of Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiation Surgery (SRS): Indirect Cell Death[J]. Int J Radiat Oncol Biol Phys, 2021, 110(1): 21-34.
[31] PAN C C, KAVANAGH B D, DAWSON L A, et al.Radiation-Associated Liver Injury[J]. Int J Radiat Oncol Biol Phys, 2010, 76(3): S94-S100.
[32] CHANDY E T J, SAXBY H J, PANG J W, et al. The Multidisciplinary Management of Oligometastases from Colorectal Cancer: A Narrative Review[J]. Ann Palliat Med, 2021, 10(5): 5988-6001.
[33] JAIN P, BAKER A, DISTEFANO G, et al.Stereotactic Ablative Radiotherapy in the UK: Current Status and Developments[J]. Br J Radiol, 2013, 86(1029): 20130331.
[34] THOMPSON R, CHEUNG P, CHU W, et al.Outcomes of Extra-Cranial Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer: Dose and Site of Metastases Matter[J]. Radiother Oncol, 2020, 142: 236-245.
[35] HØYER M, SWAMINATH A, BYDDER S, et al. Radiotherapy for Liver Metastases: A Review of Evidence[J]. Int J Radiat Oncol Biol Phys, 2012, 82(3): 1047-1057.
[36] KLEMENT R J, GUCKENBERGER M, ALHEID H, et al.Stereotactic Body Radiotherapy for Oligo-Metastatic Liver Disease - Influence of Pre-Treatment Chemotherapy and Histology on Local Tumor Control[J]. Radiother Oncol, 2017, 123(2): 227-233.
[37] JOO J H, PARK J, KIM J C, et al.Local Control Outcomes Using Stereotactic Body Radiation Therapy for Liver Metastases From Colorectal Cancer[J]. Int J Radiat Oncol Biol Phys, 2017, 99(4): 876-883.
[38] COUSSENS L M, WERB Z.Inflammation and cancer[J]. Nature, 2002, 420: 860-867.
[39] ROSENBERG S A, HENKE L E, SHAVERDIAN N, et al.A Multi-Institutional Experience of MR-Guided Liver Stereotactic Body Radiation Therapy[J]. Adv Radiat Oncol, 2019, 4(1): 142-149.
[40] FRANZESE C, COMITO T, CLERICI E, et al.Liver Metastases from Colorectal Cancer: Propensity Score-Based Comparison of Stereotactic Body Radiation Therapy vs. Microwave Ablation[J]. J Cancer Res Clin Oncol, 2018, 144(9): 1777-1783.
[41] NIEUWENHUIZEN S, DIJKSTRA M, PUIJK R S, et al.Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry[J]. Cancers (Basel), 2021, 13(17): 4303.
[42] NIEUWENHUIZEN S, DIJKSTRA M, PUIJK R S, et al.Microwave Ablation, Radiofrequency Ablation, Irreversible Electroporation, and Stereotactic Ablative Body Radiotherapy for Intermediate Size (3-5 cm) Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-Analysis[J]. Curr Oncol Rep, 2022, 24(6): 793-808.