A local therapeutic efficacy comparison of percutaneous thermal ablation for the treatment of colorectal liver metastases and hepatocellular carcinoma

Abstract

Objective To investigate the differences of local therapeutic efficacy between colorectal liver metastases and hepatocellular carcinoma with the treatment of ultrasound guided percutaneous thermal ablation.Methods From July 2004 to December 2011,under the same inclusion criteria,108 nodules of colorectal liver metastases in 69 patients,the tumor diameter ranged 0.7-6.6 cm [the average diameter was (2.3 ± 1.2) cm],and 92 nodules of hepatocellular carcinoma in 70 patients,the tumor diameter ranged 0.9-7.0 cm [the average diameter was (2.6 ± 1.3) cm],were percutaneously treated with thermal ablation guided by ultrasonography.Comparative analysis of clinical outcomes was performed retrospectively including the complete ablation rates (tumor residual rates),the local tumor progression rates,the local tumor progression time,complications related to treatment and safety margin.Results The complete ablation rate was 88.0％ in colorectal liver metastases group versus 91.3％ in hepatocellular carcinoma group (P =0.44),and the local tumor progression rate was 13.0 ％ versus 14.1 ％ (P =0.81),the median of local tumor progression time was 7.5 months versus 3.6 months (P =0.36).The ablation-related major complications were occurred in 3 patients with colorectal liver metastases,and in 2 patients with hepatocellular carcinoma (P =0.68).With the same safety margin,the tumor residual rates and local tumor progression rates of two groups were similar to each other.The comparison of intra-group showed,when using 0.5 cm as a cut-off point of safety margin to divide the two groups,the tumor residual rate of safety margin ≤0.5 cm subgroup was much higher than safety margin＞0.5 cm subgroup in colorectal liver metastases group.And in hepatocellular carcinoma group the local tumor progression rate of safety margin ≤0.5 cm subgroup was higher than safety margin＞0.5 cm subgroup.Conclusions The complete ablation rates (tumor residual rates),the local tumor progression rates,the local tumor progression time and complications related to treatment between patients with colorectal liver metastases and hepatocellular carcinoma were equivalent,and thermal ablation is a safe and effective technique for the treatment of the two liver tumors.A safety margin at least 0.5 cm is important to reduce the residual and local progression of tumor. Key words: Ultrasonography ; Liver neoplasms ; Catheter ablation ; Treatment outcome