Percutaneous image-guided ablation for hepatic metastases.

Area of Science:

• Interventional Oncology
• Hepatobiliary Medicine
• Surgical Oncology

Background:

• Hepatic metastases signify advanced disease, leading to high morbidity and mortality, particularly when locoregional treatments are not feasible.
• Factors influencing treatment decisions for liver metastases include primary tumor type, disease extent, liver function, and patient health.
• Metastatic colorectal cancer to the liver is common, with surgical resection and percutaneous ablation showing survival benefits over chemotherapy alone.

Purpose of the Study:

• To review the evidence and outcomes of percutaneous ablation for common hepatic metastases.
• To discuss patient selection, technical aspects, follow-up, and oncologic results in interventional oncology practice.

Main Methods:

• Review of existing literature on percutaneous ablation for hepatic metastases.
• Analysis of patient selection criteria, procedural techniques, and follow-up protocols.
• Evaluation of oncologic outcomes, including local tumor control and survival rates.

Main Results:

• Percutaneous ablation provides local disease control and prolongs survival for both surgical and non-surgical candidates.
• Optimal local tumor control is achieved for small hepatic metastases (≥10 mm or ≥5 mm margins), comparable to surgical resection.
• Advances in surgery increase eligibility, but many patients remain unresectable or poor surgical candidates.

Conclusions:

• Percutaneous ablation is a valuable tool for managing hepatic metastases, offering comparable local control to resection for select patients.
• Careful patient selection and adherence to technical guidelines are crucial for successful outcomes.
• This review provides a comprehensive overview for interventional oncologists managing liver metastases.