Comparison of Hepatic Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastasis

Abstract

The liver is the major site of metastasis of primary colorectal cancer. Hepatic resection (HR) is considered the standard treatment for colorectal liver metastasis. In highrisk cases, radiofrequency ablation (RFA) can be attempted as an alternative treatment. This study compared the clinical profiles and overall and disease-free survival rates of patients with colorectal liver metastasis undergoing HR and RFA. From 1995 to 2009, we retrospectively analyzed clinical experiences of 43 and 17 patients who had undergone HR and RFA for primary colorectal cancer, respectively. To compare outcomes, we investigated the 3-year overall and disease-free survival rates. The 3-year overall survival rates of patients treated with HR and RFA were 53.5 and 47.1 %, respectively (p=0.285); the disease-free survival rates were 35.0 and 26.9 %, respectively (p=0.211). In the HR and RFA groups, 30 (60.2 %) and 13 (76.5 %) patients developed recurrence, respectively (p=0.604). In the HR group, 1 patient died from postoperative liver failure, and 9 (20.9 %) developed postoperative complications, including wound infection, biliary leakage, intra-abdominal abscess, and pneumonia. In the RFA group, 1 patient (5.9 %) required prolonged inpatient care because of a procedure-related liver abscess. Although HR should be considered the first option for colorectal liver metastasis, RFA can be regarded as a primary treatment modality depending on the patient's characteristics, especially when a patient refuses surgery or has comorbidities.

Clinical analysis of ultrasound-guided radiofrequency ablation for recurrent colorectal liver metastases after hepatectomy

“…Previous studies have reported that the survival rate of patients with RFA was only moderately higher than other non-surgical treatments. Besides, extrahepatic thermal injury and needle track implantation are more likely to occur in patients undergoing RFA, which cannot achieve the same effect as surgical resection [35]. Thereby, RFA was recommended as a good supplement for recurrent colorectal liver metastases after hepatectomy.…”

“…After propensity score matching, the result showed that the median survival time of 31 patients treated with repeat hepatic resection was 36.7 months, and the OS rates of 1, 3, and 5 years were 80.6% (6), 48.4% (16), and 32.3% (21), respectively. The median survival time of 62 patients who undergo RFA was 31.9 months, and the OS rates of 1, 3, and 5 years were 75.8% (15), 43.5% (35), Table 3 Comparison of liver function indexes between two groups before and after treatment Values in parentheses are percentages; RFA: radiofrequency ablation; CEA: carcinoembryonic antigen.…”

Synchronous Colorectal Liver Metastases considering Infectious Complications: Simultaneous or Delayed Surgery?

“…However, few studies pay close attention to infectious complications. As a common complication, perioperative infection not only influences the safety but also the long-term survival of the patients [ 5 , 15 ]. Considering the complications of infection, more studies are needed on simultaneous and delayed surgery with simultaneous colorectal liver metastases.…”

The surgical component of treatment for metastatic colorectal cancer: The current state of the problem

“…У 51,4% больных удалось добиться 3-летней вы-живаемости, у 36,3% -продлить жизнь на 5 лет и более [49]. В последние годы для лечения метастазов в печени при колорек-тальном раке используют радиочастотную абляцию [50,51], правда эта процедура может вызывать различной степени выра-женности осложнений в зависимости от объема ткани, подверг-шейся абляции [51].…”

“…Преимущества от применения радиочастотной термоабля-ции в настоящее время еще не определены, поэтому при возмож-ности выполнения резекции предпочтение должно быть отдано последней [50].…”