Role of Local Thermal Intervention as A Treatment Option for Patients with Metastatic Liver Tumors

Background: The liver remains a common site of metastases. Surgical resection was previously considered the mainstay for the treatment of hepatic metastases (HMs). Currently, local ablation provides potential benefits for the treatment of such metastases with comparable results. Aim of Work: To evaluate the effect of different local thermal ablation interventions in the management of metastatic liver tumors. Methods: Our research included a total of 58 cases with 120 nodules who underwent local thermal ablation for the treatment of metastatic liver lesions. Microwave ablation (MWA) was employed for 22 cases, while radiofrequency ablation (RFA) was employed for 34 cases; two cases underwent both RFA and MWA. Technical assessment of ablation was performed using contrast-enhanced CT, dynamic MRI with DWI, or PET-CT scans conducted 4–6 weeks post-procedure to evaluate treatment response, defined by the absence of contrast enhancement at the ablation site. Follow-up was done for all cases at 3 and 6 months to evaluate recurrence rate, local tumor progression, disease-free interval, and 1-year survival. Results: The technical effectiveness was 82.5% (48 / 58) on a per-case basis and 87.7% (100 / 114 lesions) on a per-tumor basis. The intrahepatic recurrence rate was 24.14% (14 / 58) after 3 months and 20.69% (12 / 58) after 6 months. The median follow-up was 14 months (range 10-18 months), and the 1-year survival rate was 87.8%. Conclusion: RFA and MWA are very promising, minimally invasive interventions for treating secondary malignant hepatic tumors. Their application as local ablative therapies significantly enhances the role of interventional radiologists in the multidisciplinary management of oncologic cases. Keywords: Liver metastases; Thermal ablation; Microwave; Radiofrequency