Comparative study of ultrasound-guided percutaneous microwave ablation and surgical resection for colorectal cancer with liver metastasis

Abstract

Objective: To study the clinical efficacy of ultrasound-guided percutaneous microwave ablation and surgical resection for liver metastases from colorectal cancer. Methods: Retrospective analysis of 184 patients with liver metastases from colorectal cancer in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2012 to June 2017.Percutaneous microwave ablation or surgical resection for liver metastases were selected under ultrasound guidance. Subgroup analysis was performed according to the treatment of liver metastases. There were 98 patients in the microwave-only group (56 males and 42 females, aged (59±11) years) and 86 cases in the surgery-only group (56 males and 30 females, aged (56±11) years). The baseline data of the two groups were compared, and the results showed that the size of the metastatic lesions in the microwave-only group was smaller than that in the surgery-only group, and the remaining data didn't had statistical differences.The survival time of the two groups of patients was analyzed separately.According to the size of the metastases, the metastases were divided into groups with a diameter of<3 cm and a group of ≥3 cm. The survival time of patients in the microwave-only group and the surgery-only group were analyzed respectively.According to the different primary tumor grades of colorectal cancer, the survival time of patients in the simple microwave-only group and the surgery-only group in the primary tumors Duck A, Duck B, and Duck C were analyzed. Results: In the microwave-only group, the overall survival rates at 1, 3, and 5 years were 100%, 50.9%, and 20.9%; in the surgery-only group, the overall survival rates at 1, 3, and 5 years were 100%, 42.8%, and 20.8%, respectively. There was no significant difference in overall survival between the groups (P=0.972).Metastatic focus diameter ≥3 cm: the overall survival rates of 1, 3, and 5 years with microwave-only were 100%, 65.4%, and 12.1%; the overall survival rates of 1, 3, and 5 years with surgery-only were 100%, 59.5%, and 30.9%. There was no significant difference in overall survival between the groups (P=0.067). The long-term survival rate of the surgery-only group was greater than that of the microwave-only group (P=0.018).Metastasis diameter<3 cm: there was no significant difference in overall survival between the surgery-only group and the microwave-only group (P=0.103).In the treatment of Duck B and C liver metastases of primary colorectal cancer, there was no significant difference in overall survival between microwave alone and surgery alone (P=0.376, P=0.385).Multivariate analysis showed that the size of colorectal cancer metastases was an independent risk factor affecting the prognosis of patients with colorectal cancer liver metastases. Conclusions: Percutaneous microwave ablation has a good effect on colorectal cancer liver metastases and has a similar survival prognosis as surgery.For livers with color ≥ 3 cm in colorectal cancer, the long-term survival rate of the surgery-only group is greater than that of the microwave-only group.