Abstract
PurposeTo compare the therapeutic outcomes between open surgical resection (OSR) and percutaneous microwave ablation (PMWA) for colorectal liver metastasis (CRLM) ≤3 cm.MethodsIn this retrospective study, 200 consecutive patients with 306 CRLMs were reviewed. Overall survival (OS), disease-free survival (DFS), local tumour progression (LTP), intrahepatic distant recurrence, and extrahepatic metastasis were analysed to compare the therapeutic efficacy. Cox proportional hazards regression analysis was used to identify the prognostic factors for OS and DFS. Major complications and postoperative hospital stay were also assessed.ResultThe 1-, 3-, and 5-year OS rates were 91.6%, 64.1%, and 46.3%, respectively, in the PMWA group and 89.7%, 62.4% and 44.7%, respectively, in the OSR group (P=0.839). The 1-, 3-, and 5-year DFS rates were 61.9%, 44.8%, and 41.3%, respectively, in the PMWA group and 58.1%, 24.4%, and 18.3%, respectively, in the OSR group (P =0.066). The two groups had comparable 5-year cumulative rates of intrahepatic distant recurrence (P=0.627) and extrahepatic metastasis (P=0.884). The 5-year cumulative LTP rate was lower in the OSR group than in the PMWA group (P=0.023). The rate of major complications was higher in the OSR group than in the PMWA group (P =0.025), and the length of hospital stay after treatment was shorter in the PMWA group (P<0.001).ConclusionThere were no significant differences in OS or DFS between the two groups. PMWA was associated with increased LTP, fewer postoperative days and fewer major complications.
Highlights
Colorectal cancer (CRC) ranks the third most common type of malignancy in incidence and second in mortality [1]
There were no significant differences in Overall survival (OS) or disease-free survival (DFS) between the two groups
percutaneous microwave ablation (PMWA) was associated with increased local tumour progression (LTP), fewer postoperative days and fewer major complications
Summary
Colorectal cancer (CRC) ranks the third most common type of malignancy in incidence and second in mortality [1]. As the gold standard treatment for colorectal liver metastasis (CRLM), surgery prolongs the overall. Percutaneous Microwave Ablation, Liver Metastasis survival (OS) of patients, with 5-year survival rates of up to 51% [5]. Several communities have performed comparative studies on the effectiveness and safety of radiofrequency ablation (RFA) and resection. The results showed that RFA and resection had similar OS rates for patients with CRLM ≤3 cm, and the recurrence rate was higher in patients treated with RFA than in patients treated with resection. The complication rate was lower for RFA. The outcome demonstrated that recurrence was the dominant factor restricting the popularization of RFA
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