Abstract
The outcome of radiofrequency ablation (RFA) for liver metastases from colorectal cancer (CRLM) has been thought to be inferior to metastasectomy. However, the recent development of multielectrode RFA (multi-RFA) systems has made the ablation zone larger and more complete. Thus, we assessed the survival benefits of this modality in cases of metachronous CRLM. This retrospective study assessed patients diagnosed with resectable metachronous CRLM between 2013 and 2016; 132 patients were categorized by treatment for liver metastases: multi-RFA (n = 68), hepatectomy (n = 34), or systemic treatment only (n = 30). Therapeutic effectiveness, outcomes, and intervention-related complications were compared between groups. Median overall survival (OS), recurrence-free survival (RFS), and intrahepatic recurrence-free survival (IHRFS) were 69.8, 85.2, and 59.7 months for the hepatectomy group; 53.4, 41.3, and 32.3 months for the multi-RFA group; and 19.1, 7.1, and 7.1 months for the systemic treatment group. No significant differences were observed between the multi-RFA and hepatectomy groups after a median follow-up of 59.8 months. This study demonstrated that multi-RFA and hepatectomy provide similar survival benefits for patients with resectable CRLM. Multi-RFA may represent a reliable treatment option for the management of resectable liver metastases.
Highlights
Colon cancer is the third most frequently diagnosed cancer and has the second highest mortality rate worldwide, accounting for one-tenth of all cancer cases and deaths annually [1]
We identified patients with resectable metachronous liver metastases due to colorectal cancer and grouped these patients according to the treatment used for liver metastases: hepatectomy, multi-radiofrequency ablation (RFA), or systemic treatment only (Figure 1)
The 132 patients included in the final study cohort were categorized into three groups according to the initial treatment for liver metastases: multi-RFA, hepatectomy, and systemic treatment only
Summary
Colon cancer is the third most frequently diagnosed cancer and has the second highest mortality rate worldwide, accounting for one-tenth of all cancer cases and deaths annually [1]. Colon cancer is the most common form of cancer in Taiwan [2], and the liver is the most common metastatic site [3]. 25% of patients with colon cancer have liver metastases (CRLM) at initial diagnosis, and 50% develop metachronous liver metastases [4]. Liver metastasis can develop synchronously or metachronously. The relatively poor prognosis of synchronous metastatic liver disease has been suggested to be attributed to the fact it is more disseminated than metachronous metastatic liver disease [5]. The median survival of patients with CRLM receiving palliative care is between
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