Clinical analysis of ultrasound-guided radiofrequency ablation for recurrent colorectal liver metastases after hepatectomy

Xiao-Xiang Fan,Xiao-Yu Dai,Da-Feng Mao,Mei-Wu Zhang,Yan Zhang,Shu-Yi Lv,Jian-Pei Zhao

doi:10.1186/s12957-020-01849-0

Abstract

BackgroundRFA is designed to produce localized tumor destruction by heating the tumor and surrounding liver tissue, especially suitable for patients who do not qualify for hepatic resection. Many studies have reported that RFA was inferior to hepatectomy in the treatment of recurrent colorectal liver metastases. However, strong evidence is lacking in the literature. This study aimed to investigate the effect and clinical outcome of percutaneous ultrasound-guided RFA and repeat hepatic resection for recurrent colorectal liver metastases after hepatectomy.MethodsFrom January 2007 to January 2014, 194 patients with recurrent colorectal liver metastases after hepatectomy diagnosed in our hospital was performed, and then divided into two groups based on different regimens: repeat hepatic resection group and RFA group. The clinical data of the two groups were analyzed. After treatment, the liver function-related indexes, complication rate, survival rate, and tumor recurrence of the two groups were recorded. The difference in short-term and long-term effects between repeat hepatic resection and RFA was identified by propensity score analysis.ResultsThe number of metastases and the proportion of left and right lobe involved by tumor and preoperative chemotherapy in the RFA group were higher than those in the repeat hepatic resection group. The clinical data showed no significant difference between the two groups after using propensity score analysis. Compared with the RFA group, the liver function of the repeat hepatic resection group was significantly improved. After adjustment for potential confounders, no significant difference in liver function-related indexes was found between RFA and repeat hepatic resection, and the incidence of complications in the RFA group was lower. In survival analysis, there was no significant difference in OS and DFS between the two groups.ConclusionsRFA is a safe and effective therapeutic option for patients with recurrent colorectal liver metastases after hepatectomy.

Highlights

radiofrequency ablation (RFA) is designed to produce localized tumor destruction by heating the tumor and surrounding liver tissue, especially suitable for patients who do not qualify for hepatic resection
The number of metastases in the RFA group was higher than that in the repeat hepatic resection group (P = 0.022), and the proportion of left and right lobe involved by tumor was 47.9%, obviously higher than that of repeat
No significant difference in liver function-related indexes was found between RFA and repeat hepatic resection after matching (Table 3)

Summary

Introduction

RFA is designed to produce localized tumor destruction by heating the tumor and surrounding liver tissue, especially suitable for patients who do not qualify for hepatic resection. Non-surgical treatment should be considered [14,15,16,17,18] Thermal ablation procedures such as radiofrequency ablation (RFA) offers the advantages of security, efficiency, minimally invasive, and can cause coagulation necrosis of the tumor with avoidance of unnecessary surgery, especially for patients who are not candidates for hepatic resection [19, 20]. For this reason, RFA has been widely applied in clinical treatment [21, 22]. This study explored the role and status of percutaneous ultrasoundguided RFA in the comprehensive treatment of recurrent colorectal liver metastases after hepatectomy

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