Combined microwave ablation and systemic chemotherapy for liver metastases from oesophageal cancer: Preliminary results and literature review

Figures & data

Figure 1. Enrolment of patients who received microwave ablation for liver metastases from oesophageal squamous cell carcinoma at our department.

Table 1. Clinicopathological characteristics of 15 patients with liver metastases from oesophageal squamous cell carcinoma.

Patient no.	Sex	Primary oesophageal cancer			Interval from oesophagectomy to liver metastases (months)	Location of liver metastases	Parameters at initial MWA
		Location	Differentiation	TNM stage			Age (years)	KPS score	CEA (μg/L)
1	M	Lt	Moderate	IIA	36	VII	63	80	2.51
2	M	Mt	Moderate	IIB	49	III	64	80	2.60
3	M	Lt	Well	IIA	53	V, VI	56	90	1.83
4	M	Lt	Moderate	IIIB	6	IV, VII	62	90	3.13
5	M	Mt	Poor	IIIA	5	IV, VII	72	90	2.30
6	M	Lt	Poor	IIA	7	V, V, VII	62	80	28.33
7	F	Lt	Moderate	IIB	4	VIII	78	70	2.27
8	M	Lt	Poor	IIA	9	II, III	50	90	0.84
9	M	Lt	Well	IIIB	11	V, VI, VI	63	90	138.5
10	M	Ut	Moderate	IIIA	22	III	50	90	2.60
11	M	Lt	Poor	IIIA	20	VII, VII	49	90	11.08
12	M	Lt	Poor	IIB	4	VII	54	80	2.60
13	M	Mt	Poor	IIIB	3	V, VII	44	90	1.60
14	F	Lt	Well	IIB	36	VI	67	90	3.42
15	M	Lt	Well	IIA	10	V	55	90	2.26

Roman numerals indicate Couinaud liver segments. Lt, lower thoracic oesophagus; Mt, middle thoracic oesophagus; Ut, upper thoracic oesophagus; KPS, Karnofsky performance scale; CEA, carcinoembryonic antigen.

Table 2. Parameters of liver metastases and microwave ablation treatment

Parameter	Mean	Median	Range
No. of metastases per patient	1.67	2	1–3
Diameter of liver metastases (cm)	2.97	3	0.9–4.8
No. of treatment sessions per patient	1.53	1	1–3
No. of antennae per metastasis	1.88	2	1–2
Ablation power (W)	51.2	50	50–60
Ablation time per metastasis (s)	439.6	360	150–780

Figure 2. Overall survival and progression-free survival of 15 patients after combined microwave ablation and systemic chemotherapy for liver metastases from oesophageal squamous cell carcinoma.

Table 3. Clinical characteristics of three patients who were still alive at the last follow-up.

Patient no.	Time from oesophagectomy to liver metastases	Number of liver metastases	Tumour size (cm)	Time of living since initial MWA (months)	Post-oesophagectomy treatment
1	36	1	3.0	19	Chemoradiotherapy
3	53	2	4.7, 1.2	48	Chemotherapy
15	10	1	3.4	24	Chemoradiotherapy

Table 4. Summary of literature regarding treatment for metachronous liver metastases from oesophageal cancer.

Author and year	Nation	Patient no.	Treatment for liver metastases	Survival outcome
Andreou et al. 2014 [17]	Italy	4	Hepatectomy	5-year overall survival rate 25%
Huddy et al. 2014 [4]	UK	4	Liver resection	Two alive at 22 and 92 months; two died at 21 and 10 months
Ichida et al. 2013 [5]	Japan	5	Hepatic resection	Median survival 13 months
Wang et al. 2013 [9]	China	20	Systemic chemotherapy of FOLFOX regimen	Median progression-free survival 2.4 months, median overall survival 6.7 months
Iitaka et al. 2013 [14]	Japan	1	RF ablation, systemic docetaxel and hepatectomy	Local liver recurrence 8 months after RF ablation
Muro et al. 2004 [19]	Japan	11	Systemic docetaxel	Response rate 18%
Ikeda et al. 2003 [18]	Japan	1	Conformal radiotherapy	Tumour size decreased in the following 6 months
Nakajima et al. 2001 [21]	Japan	8	CDDP + 5-FU (hepatic arterial infusion chemotherapy)	Overall response rate 50%
Iwahashi et al. 1999 [23]	Japan	4	Hepatic arterial infusion chemotherapy of CDDP and 5-FU + hyperthermotherapy	All patients showed partial response, 3 patients lived more than 17 months

RF, radiofrequency; CDDP, cisplatin; 5-FU, fluouracil.

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