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Open AccessCase Report

Immunomodulatory Changes Following Isolated RF Ablation in Colorectal Liver Metastases: A Case Report

Department of Immunology, Tbilisi State Medical University, 0186 Tbilisi, Georgia
Department of Surgery and Cancer, Imperial College London, London W120HS, UK
General, Emergency and Robotic Surgery Unit, San Francesco Hospital, 08100 Nuoro, Italy
Department of Interventional Radiology, Tbilisi State Medical University, 0144 Tbilisi, Georgia
Authors to whom correspondence should be addressed.
Medicines 2019, 6(2), 56;
Received: 10 April 2019 / Revised: 6 May 2019 / Accepted: 7 May 2019 / Published: 13 May 2019
PDF [2653 KB, uploaded 13 May 2019]


Background: Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths in developed countries. The liver is the most prevalent site of metastasis from CRC. Currently, the gold-standard treatment for colorectal liver metastases (CLMs) is surgical resection. However, depending on the pattern of the disease, a significant number of patients may require different approaches alone or in combination with surgery, including thermal ablation (radiofrequency (RFA) or microwave (MWA) ablation) or transarterial liver-directed therapies, although the latter is not yet part of the standard treatment for CRC liver metastases. Methods and Results: We present the case of a 63-yearold man with bilobar CLM who was treated with transarterial embolization (TAE) and RFA followed by chemotherapy. A post-RFA study of immune parameters revealed the downregulation of CD39 expression in the circulating CD4+ T cell population and a reduction of the serum levels of cytokines IL-10, TGF-β, IFN-gamma and IL-17, which positively correlated with the diminished serum level of gamma-glutamyl transferase (GGT) and the subdued inflammatory markers: the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). Later, the patient underwent chemotherapy. Liver failure developed within two years and nine months following tumour ablation, leading to the death of the patient. Conclusions: However, the denial of adjuvant chemotherapy by the patient gave us the opportunity to assess the immunomodulatory changes following RFA in the absence of any other therapeutic modalities. View Full-Text
Keywords: colorectal cancer; immunomodulation colorectal cancer; immunomodulation

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Janikashvili, N.; Jayant, K.; Kikodze, N.; Mazmishvili, K.; Pantsulaia, I.; Sandhu, B.; Podda, M.; Iobadze, M.; Azrumelashvili, T.; Mizandari, M.; Habib, N.; Chikovani, T. Immunomodulatory Changes Following Isolated RF Ablation in Colorectal Liver Metastases: A Case Report. Medicines 2019, 6, 56.

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