Background: Evaluate efficacy and safety of a combined therapy for liver metastases treatment
>3 cm, using a two-step single session combined approach of transarterial embolization
(TAE) followed by percutaneous microwave ablation (MWA) for curative intent. Method(s): Between January 2015 and December 2017, 24 technically unresectable liver metastases
>3 cm were selected for the combined treatment. The percentile variation in ablated
tissue volume with respect to a stand-alone thermal coagulation therapy (δv) was calculated.
The final ablation volume (VE-T) was compared with the initial nodule volume (VN)
and the expected ablation volume of stand-alone MWA (VT). Technical success was defined
as complete target devascularization at the immediate post-procedural CT. One, 3,
6 and 12 months post-procedure follow-up was performed and major and minor complications
were reported. Result(s): Tumor dimension ranged from 32 to 73 mm. Full technical success was achieved in all
treated tumors. The final ablation volumes were in the range 50-450 cm3 with short-axis
diameter of the ablation zone ranged between 12 and 48 mm. The mean δv increment in
final ablation volume with respect to stand-alone MWA was 196% (range: 25 cm3 – 210
cm3) (p<0.05). The VE-t mean was 4 times the VN mean, while the VT mean was about
twice the VN mean. No recurrence and only one major complication were observed. Conclusion(s): Our results provide preliminary evidence of efficacy, obtaining a larger necrotic
area, and safety, for the low complication rate, of a combined two-step single-session
TAE-MWA treatment of unresectable hepatic metastasis >3 cm.
