The comparative analysis of the treatment efficacy in patients with primary and secondary cancer of a liver with the use of RFA and MWA

Abstract

Background: Surgical resection is the standard treatment for colorectal liver metastases(CRLM). The use of ablation in combination with resection allows more patients to benefit from cure .We report the outcomes & recurrence rates of ablation & resection vs liver resection alone for CRLM. Methods: We analysed prospectively maintained data base of 133 consecutive patients from 2012-2016 who underwent surgical treatment for CRLM.107patients underwent resection alone & 26 had resection & ablation. Results: Baseline variables like age,BMI,preoperative ALT, Bilirubin,INR,CEA &size of largest lesion on imaging were similar in both groups.The mean operative time244 mins was higher in ablation&resection vs.178 mins in resection only (P<0.01). The mean intra-operative blood loss was similar in both groups P=0.17. The mean number of lesions on histology, the largest lesion on histology and the distance from resection margin on histology were similar(3.8 vs 2.1 P=0.002, 33 vs 38 mm P= 0.418 and 20.5 vs 6.1 mm P= 0.54).In ablation & resection group 38% patients had R1 resection as compared to 22% in resection group.1 year liver and multiorgan recurrence rates were 46%and 15% in ablation &resection group as compared to 19.6% and 12.11%. The overall recurrence rate in ablation & resection group was 34.6% vs 56.1% in resection. Conclusion: There is higher recurrence rate in ablation & resection group compared to resection only group reflecting advanced disease in the group but we believe ablation till has a role in curative treatment.