Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry
Thermal ablation and stereotactic ablative radiotherapy (SABR) are techniques to eradicate colorectal liver metastases (CRLM). This study compares the safety, efficacy and long-term oncological outcomes of these treatment methods. All prospectively registered patients (AmCORE registry) treated with...
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MDPI AG
2021-08-01
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Online Access: | https://www.mdpi.com/2072-6694/13/17/4303 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sanne Nieuwenhuizen Madelon Dijkstra Robbert S. Puijk Florentine E. F. Timmer Irene M. Nota Jip Opperman Bente van den Bemd Bart Geboers Alette H. Ruarus Evelien A. C. Schouten Jan J. J. de Vries Hester J. Scheffer Anne M. van Geel Jan Hein T. M. van Waesberghe Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Cornelis J. A. Haasbeek Martijn R. Meijerink |
spellingShingle |
Sanne Nieuwenhuizen Madelon Dijkstra Robbert S. Puijk Florentine E. F. Timmer Irene M. Nota Jip Opperman Bente van den Bemd Bart Geboers Alette H. Ruarus Evelien A. C. Schouten Jan J. J. de Vries Hester J. Scheffer Anne M. van Geel Jan Hein T. M. van Waesberghe Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Cornelis J. A. Haasbeek Martijn R. Meijerink Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry Cancers colorectal liver metastases (CRLM) thermal ablation microwave ablation (MWA) radiofrequency ablation (RFA) stereotactic ablative radiotherapy (SABR) |
author_facet |
Sanne Nieuwenhuizen Madelon Dijkstra Robbert S. Puijk Florentine E. F. Timmer Irene M. Nota Jip Opperman Bente van den Bemd Bart Geboers Alette H. Ruarus Evelien A. C. Schouten Jan J. J. de Vries Hester J. Scheffer Anne M. van Geel Jan Hein T. M. van Waesberghe Rutger-Jan Swijnenburg Kathelijn S. Versteeg Birgit I. Lissenberg-Witte M. Petrousjka van den Tol Cornelis J. A. Haasbeek Martijn R. Meijerink |
author_sort |
Sanne Nieuwenhuizen |
title |
Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry |
title_short |
Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry |
title_full |
Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry |
title_fullStr |
Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry |
title_full_unstemmed |
Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE Registry |
title_sort |
thermal ablation versus stereotactic ablative body radiotherapy to treat unresectable colorectal liver metastases: a comparative analysis from the prospective amsterdam core registry |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2021-08-01 |
description |
Thermal ablation and stereotactic ablative radiotherapy (SABR) are techniques to eradicate colorectal liver metastases (CRLM). This study compares the safety, efficacy and long-term oncological outcomes of these treatment methods. All prospectively registered patients (AmCORE registry) treated with thermal ablation or SABR alone for unresectable CRLM between 2007 and 2020 were analyzed using multivariate Cox-proportional hazard regression. In total 199 patients were included for analysis: 144 (400 CRLM) thermal ablation; 55 (69 CRLM) SABR. SABR patients were characterized by older age (<i>p</i> = 0.006), extrahepatic disease at diagnosis (<i>p</i> = 0.004) and larger tumors (<i>p</i> < 0.001). Thermal ablation patients were more likely to have synchronous disease, higher clinical risk scores (<i>p</i> = 0.030) and higher numbers of CRLMs treated (<i>p</i> < 0.001). Mortality was zero and morbidity low in both groups: no serious adverse events were recorded following SABR (<i>n</i> = 0/55) and nine (<i>n</i> = 9/144 [6.3%]; all CTCAE grade 3) after thermal ablation. SABR was associated with an inferior overall survival (OS) (median OS 53.0 months vs. 27.4 months; HR = 1.29, 95% CI 1.12–1.49; <i>p</i> = 0.003), local tumor progression-free survival (LTPFS) per-tumor (HR = 1.24, 95% CI 1.01–1.52; <i>p</i> = 0.044) and local control per-patient (HR = 1.57, 95% CI 1.20–2.04; <i>p</i> = 0.001) and per-tumor (HR = 1.89, 95% CI 1.44–2.49; <i>p</i> < 0.001). In this study thermal ablation was superior to SABR with regard to OS, LTPFS and local control, albeit at the cost of a limited risk of serious adverse events. Further studies are required to assess whether the worse outcomes following SABR were the effect of true differences in ablative treatment or a result of residual confounding. |
topic |
colorectal liver metastases (CRLM) thermal ablation microwave ablation (MWA) radiofrequency ablation (RFA) stereotactic ablative radiotherapy (SABR) |
url |
https://www.mdpi.com/2072-6694/13/17/4303 |
work_keys_str_mv |
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doaj-bcc490ce9a3c40408e80a0106599a1c82021-09-09T13:40:23ZengMDPI AGCancers2072-66942021-08-01134303430310.3390/cancers13174303Thermal Ablation versus Stereotactic Ablative Body Radiotherapy to Treat Unresectable Colorectal Liver Metastases: A Comparative Analysis from the Prospective Amsterdam CORE RegistrySanne Nieuwenhuizen0Madelon Dijkstra1Robbert S. Puijk2Florentine E. F. Timmer3Irene M. Nota4Jip Opperman5Bente van den Bemd6Bart Geboers7Alette H. Ruarus8Evelien A. C. Schouten9Jan J. J. de Vries10Hester J. Scheffer11Anne M. van Geel12Jan Hein T. M. van Waesberghe13Rutger-Jan Swijnenburg14Kathelijn S. Versteeg15Birgit I. Lissenberg-Witte16M. Petrousjka van den Tol17Cornelis J. A. Haasbeek18Martijn R. Meijerink19Department of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Noordwest Ziekenhuisgroep, 1815 JD Alkmaar, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Noordwest Ziekenhuisgroep, 1815 JD Alkmaar, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Surgery, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Epidemiology and Data Science, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiation Oncology, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Cancer Center Amsterdam, VU University, 1081 HV Amsterdam, The NetherlandsThermal ablation and stereotactic ablative radiotherapy (SABR) are techniques to eradicate colorectal liver metastases (CRLM). This study compares the safety, efficacy and long-term oncological outcomes of these treatment methods. All prospectively registered patients (AmCORE registry) treated with thermal ablation or SABR alone for unresectable CRLM between 2007 and 2020 were analyzed using multivariate Cox-proportional hazard regression. In total 199 patients were included for analysis: 144 (400 CRLM) thermal ablation; 55 (69 CRLM) SABR. SABR patients were characterized by older age (<i>p</i> = 0.006), extrahepatic disease at diagnosis (<i>p</i> = 0.004) and larger tumors (<i>p</i> < 0.001). Thermal ablation patients were more likely to have synchronous disease, higher clinical risk scores (<i>p</i> = 0.030) and higher numbers of CRLMs treated (<i>p</i> < 0.001). Mortality was zero and morbidity low in both groups: no serious adverse events were recorded following SABR (<i>n</i> = 0/55) and nine (<i>n</i> = 9/144 [6.3%]; all CTCAE grade 3) after thermal ablation. SABR was associated with an inferior overall survival (OS) (median OS 53.0 months vs. 27.4 months; HR = 1.29, 95% CI 1.12–1.49; <i>p</i> = 0.003), local tumor progression-free survival (LTPFS) per-tumor (HR = 1.24, 95% CI 1.01–1.52; <i>p</i> = 0.044) and local control per-patient (HR = 1.57, 95% CI 1.20–2.04; <i>p</i> = 0.001) and per-tumor (HR = 1.89, 95% CI 1.44–2.49; <i>p</i> < 0.001). In this study thermal ablation was superior to SABR with regard to OS, LTPFS and local control, albeit at the cost of a limited risk of serious adverse events. Further studies are required to assess whether the worse outcomes following SABR were the effect of true differences in ablative treatment or a result of residual confounding.https://www.mdpi.com/2072-6694/13/17/4303colorectal liver metastases (CRLM)thermal ablationmicrowave ablation (MWA)radiofrequency ablation (RFA)stereotactic ablative radiotherapy (SABR) |