The efficacy of treatment using radiofrequency ablation versus surgical resection in colorectal cancer liver metastases

Abstract

Objective To compare the efficacy of radiofrequency ablation versus surgical resection in treatment of colorectal liver metastases with a maximum diameter ≤ 3 cm and a number ≤ 3, and to analyze the risk factors of recurrence. Methods The data of 97 patients with colorectal liver metastases from January 2012 to June 2016 treated at Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. There were 66 males and 31 females. The patients were divided into the radiofrequency ablation group (23 patients) and the surgical resection group (74 patients). The patients were followed up. The clinicopathological features of the two groups before treatment were compared. Kaplan-Meier curves were drawn, and the recurrence-free survival curve and overall survival curve of the two groups were compared by log-rank test. Univariate and multivariate Cox regression analysis was used to analyze the risk factors of recurrence. Results There were no significant differences in age, location of primary tumor, number and size of liver metastases, and preoperative carcinoembryonic antigen level between the two groups (P>0.05). On the date this study was censored, there were 50 patients who had developed recurrence in the surgical resection group and 22 patients in the ablation group, (67.6% vs. 95.7%). The difference was significant (P 0.05). Univariate and multivariate analysis showed that N 1~2 staging (HR=1.908, 95%CI: 1.094~3.325), simultaneous liver metastasis (HR=1.662, 95%CI: 1.024~2.695) and radiofrequency ablation (HR=2.708, 95%CI: 1.589~4.617) were independent risk factors of recurrence for colorectal liver metastasis. Conclusions Radiofrequency ablation can achieve complete ablation in patients with colorectal liver metastases with maximum diameter ≤ 3 cm and number ≤ 3, but the recurrence rate of radiofrequency ablation is significantly higher than that of surgical resection. N 1~2 staging, simultaneous liver metastasis and radiofrequency ablation were independent risk factors for recurrence of colorectal liver metastasis. Key words: Colorectal neoplasms; Neoplasm metastasis; Liver neoplasm; Surgical procedures, operative; Radiofrequency ablation