Treatment of liver metastases of colorectal carcinoma: Overview of hyperthermal ablation methods [Therapie von Lebermetastasen des kolorektalen Karzinoms: übersicht der hyperthermen Ablationsverfahren]

摘要

Aim and method: This paper presents the basic techniques and clinical results of the most common hyperthermal ablation methods for patients with malignant liver metastases of colorectal carcinoma. An overview of recently published data is provided using selected articles from the literature and our own clinical experience in an interdisciplinary liver centre. Results: Radiofrequency ablation (RFA), microwave ablation (MWA) and laser ablation (LITT) show comparable results concerning survival data. Local recurrence is less frequent after LITT (7,1-10 %) than after RFA (32-44 %) and MWA (7-15 %). Survival depends on many factors. The 3-year survival rate for RFA ranges from 20,2-71,3 %, for MWA it is 51,1 % and for LITT from 56-77 %. Mean complication rates range from 1,8-10 %. Recent studies showed promising results after combined therapy of regional chemotherapy or regional radiotherapy with thermal ablation. Conclusion: Ablation methods such as RFA, MWA and LITT show good local tumor control with low complication rates and are usually performed on an outpatient basis. Indications are < 5 metastases limited to the liver with a maximum diameter of ≤ 4 cm when surgical resection is contraindicated or has been previously performed. The decision should be made by an interdisciplinary tumor board.