Comparison of clinical efficacy between radiofrequency ablation and surgical resection for colorectal cancer liver metastasis

Abstract

Objective To compare the clinical efficacy between radiofrequency ablation (RFA) and surgical resection for colorectal cancer liver metastasis (CLM). Methods Clinical data of 40 patients with CLM who were admitted to the Third Affiliated Hospital of Sun Yat-sen University between January 2010 and December 2013 were retrospectively analyzed. According to the treatment methods, the patients were divided into the RFA group (n=21) and surgical resection group (n=19). In the RFA group, 13 cases were males and 8 females, aged (58±10) years old on average. In the surgical resection group, 10 cases were males and 9 females, aged (59±8) years old on average. The informed consents of all patients were obtained and the local ethical committee approval was received. The diameter and number of the liver metastases in two group was respectively≤5 cm and≤3, and the patients underwent radical resection of colorectal cancer in the same period. The incidence of postoperative complications, tumor recurrence and survival were observed in two groups. The rate was compared using Chi-square test or Fisher's exact probability test. Results In the RFA group, postoperative abdominal pain was observed in 3 cases, fever in 7 and abdominal hemorrhage in 1. In the surgical resection group, postoperative bile leakage was observed in 2 cases, subphrenic abscess in 1, wound infection in 2 and abdominal hemorrhage in 1. All patients recovered and discharged after conservative therapy. The 3-year local recurrence rate was 14% (3/21) in the RFA group and 5% (1/19) in the surgical resection group, and no significant difference was observed (P>0.05). The 1-, 3-year survival rate was respectively 90% (19/21) and 71% (15/21) in the RFA group, 89% (17/19) and 74% (14/19) in the surgical resection group, and no significant differences were observed (χ2=0.000, 0.025; P>0.05). Conclusions RFA is a feasible treatment for the CLM patients with the diameter of liver metastases≤5 cm and the number≤3. Compared with surgical resection, RFA has the same clinical efficacy and the advantage of minimal invasion. Key words: Colorectal neoplasms; Liver neoplasms; Neoplasm metastasis; Ablation techniques; Hepatectomy; Comparative effectiveness research