Ablative margins in percutaneous thermal ablation of hepatic tumors: a systematic review
Publication year
2023Source
Expert Review of Anticancer Therapy, 23, 9, (2023), pp. 977-993ISSN
Publication type
Article / Letter to editor
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Organization
Surgery
Medical Imaging
Neurosurgery
Journal title
Expert Review of Anticancer Therapy
Volume
vol. 23
Issue
iss. 9
Page start
p. 977
Page end
p. 993
Subject
Radboudumc 10: Reconstructive and regenerative medicine Surgery; Radboudumc 14: Tumours of the digestive tract Medical Imaging; Radboudumc 14: Tumours of the digestive tract Surgery; Radboudumc 15: Urological cancers Medical Imaging; Radboudumc 15: Urological cancers Neurosurgery; Medical Imaging - Radboud University Medical CenterAbstract
INTRODUCTION: This study aims to systematically review current evidence on ablative margins and correlation to local tumor progression (LTP) after thermal ablation of hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM). METHODS: A systematic search was performed in PubMed (MEDLINE) and Web of Science to identify all studies that reported on ablative margins (AM) and related LTP rates. Studies were assessed for risk of bias and synthesized separately per tumor type. Where possible, results were pooled to calculate risk differences (RD) as function of AM. RESULTS: In total, 2910 articles were identified of which 43 articles were eligible for final analysis. There was high variability in AM measurement methodology across studies in terms of measurement technique, imaging modalities, and timing. Most common margin stratification was < 5 mm and > 5 mm, for which data were available in 25/43 studies (58%). Of these, all studies favored AM > 5 mm to reduce the risk of LTP, with absolute RD of 16% points for HCC and 47% points for CRLM as compared to AM < 5 mm. CONCLUSIONS: Current evidence supports AM > 5 mm to reduce the risk of LTP after thermal ablation of HCC and CRLM. However, standardization of AM measurement and reporting is critical to allow future meta-analyses and improved identification of optimal threshold value for clinical use.
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- Academic publications [245186]
- Electronic publications [132486]
- Faculty of Medical Sciences [93207]
- Open Access publications [106066]
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