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01-08-2021 | Metastasis | Original Article

Percutaneous ablation of post-surgical solitary early recurrence of colorectal liver metastases is an effective “test-of-time” approach

Authors: Luca Vigano, Jacopo Galvanin, Dario Poretti, Daniele Del Fabbro, Damiano Gentile, Vittorio Pedicini, Luigi Solbiati, Guido Torzilli

Published in: Updates in Surgery | Issue 4/2021

Abstract

Standard treatment of early recurrence of colorectal liver metastases (CLM) after liver resection (LR) is chemotherapy followed by loco-regional therapy. We reviewed the outcome of a different strategy (“test-of-time” approach): upfront percutaneous ablation without chemotherapy. Twenty-six consecutive patients with early solitary liver-only recurrence amenable to both resection and ablation (< 30 mm, distant from vessels) undergone “test-of-time” approach were analyzed. Early recurrence had a median size of 17 mm and occurred after a median interval from LR of 4 months. Primary efficacy rate of ablation was 100%. Five patients are alive and disease-free after a mean follow-up of 46 months. Five patients had local-only recurrence; all had repeat treatment (LR = 4; Ablation = 1) without chemotherapy. Local recurrence risk was associated with incomplete ablation of 1-cm thick peritumoral margin. The remaining 16 patients had non-local recurrence, 13 early after ablation. Overall, six (23%) patients had ablation as unique treatment and 13 (50%) avoided or postponed chemotherapy (mean chemotherapy-free interval 33.5 months). Ablation without chemotherapy of early liver-only recurrence is a reliable “test-of-time” approach. It minimized the invasiveness of treatment with good effectiveness and high salvageability in case of local failure, avoided worthless surgery, and saved chemotherapy for further disease progression.

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Title: Percutaneous ablation of post-surgical solitary early recurrence of colorectal liver metastases is an effective “test-of-time” approach
Authors: Luca Vigano
Jacopo Galvanin
Dario Poretti
Daniele Del Fabbro
Damiano Gentile
Vittorio Pedicini
Luigi Solbiati
Guido Torzilli
Publication date: 01-08-2021
Publisher: Springer International Publishing
Keywords: Metastasis
Liver Resection
Liver Resection
Cytostatic Therapy
Published in: Updates in Surgery / Issue 4/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-021-01047-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Percutaneous ablation of post-surgical solitary early recurrence of colorectal liver metastases is an effective “test-of-time” approach

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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