ARTORG Center for Biomedical Engineering Research


2023/06/08 | Research | Surgical technologies

Stereotactic thermoablation effective treatment alternative for colorectal cancer liver metastases

Treatment of colorectal cancer liver metastases has long been based on partial removal of the liver. A study involving a research team from Inselspital, University Hospital Bern, and the ARTORG IGT group, has now shown that a tissue-sparing treatment using a microwave probe, known as thermoablation, offers just as high a survival rate for colorectal cancer liver metastases as the conventional partial removal of the liver.

In thermoablation, a probe is placed in the tumor via the smallest possible incision site and the tumor tissue is destroyed by the application of heat (known as ablation). (Adrian Moser © University of Bern)
This type of treatment is easy to apply and, compared to partial liver removal, less invasive for the surrounding tissue - which also means a faster recovery for patients. (Adrian Moser © UniBE)

Multicenter study comparing two treatment methods

A team led by Prof. Daniel Candinas, MD, Head and Chief Physician at the University Department of Visceral and Transplant Surgery at Inselspital, and the University of Bern, in collaboration with other European centers, has investigated whether thermoablation is equivalent to conventional partial liver resection in terms of survival. For the study, 98 patients were recruited for thermoablation at three European hospitals. All subjects had no more than five liver metastases, each no larger than 30 mm. The study participants were all eligible for both thermoablation and partial liver resection. Subjects were compared with a control group of patients from the Swedish Liver Registry who underwent partial liver removal.

In this study, thermal ablations were performed with the highest precision possible today using a computer-assisted navigation device. This device was originally developed by the Image Guided Therapy group of the ARTORG Center for Biomedical Engineering Research at the University of Bern, and uses a technically complex imaging process of magnetic resonance and computed tomography to precisely guide the microwave probe to the tumor (picture 2 above).

Thermoablation effective treatment alternative to liver removal

The results of the study show that treatment of small colorectal cancer liver metastases using stereotactic thermoablation leads to similar patient survival as partial liver removal: 3 years after treatment, survival was nearly identical in the two groups (78% after thermoablation versus 76% after liver removal). In addition, thermoablation had significantly lower treatment-related mortality while providing more opportunities for liver retreatment during the course of the disease. These results underscore that thermal ablation is an effective and less burdensome treatment alternative for patients with small colorectal cancer liver metastases. This is confirmed by Prof. Candinas:

"The study is an important milestone as it demonstrates for the first time in a methodologically very tight and well defined setting that small metastases in the liver from colorectal tumors can be treated with stereotactic microwave ablation on par with surgical therapy. Considering that in the meantime more than 8000 thermoablations have been performed with this system in 17 countries worldwide, we will certainly see more data soon confirming the results of this study and also consolidating the other indications in the field of oncological treatments."