Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepatopancreatobiliary Surgery Unit I, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
World J Surg Oncol. 2018 Oct 15;16(1):207. doi: 10.1186/s12957-018-1494-3.
Liver resection is the first-line treatment for patients with resectable colorectal liver metastasis (CRLM), while radiofrequency ablation (RFA) can be used for small unresectable CRLM because of disease extent, poor anatomical location, or comorbidities. However, the long-term outcomes are unclear for RFA treatment in resectable CRLM. This study aimed to compare the recurrence rates and prognosis between resectable CRLM patients receiving either liver resection or RFA.
Consecutive patients who underwent RFA or hepatic resection from November 2010 to December 2015 were assigned in this retrospective study. Propensity score analysis was used to eliminate baseline differences between groups. Survival and recurrence rates were compared between patients receiving liver resection and RFA.
With 1:2 ratio of propensity scoring, 46 patients in the RFA group and 92 in the resection group were successfully matched. Overall survival was similar between the two groups, but the resection group had a higher disease-free survival (median, 22 months vs. 14 months). Whereas among patients with a tumor size of ≤ 3 cm, disease-free survival was similar in the two groups (median, 24 months vs. 21 months). Compared to the resection group, the RFA group had a higher rate of intrahepatic recurrence (34.8% vs. 12.0%) and a shorter recurrence free period. The local and systemic recurrence rate and recurrence-free period for the same were insignificant in the two groups. Poor disease-free survival was associated with RFA, T4, tumor diameter > 3 cm, and lymph node positivity.
Among patients with technically resectable CRLM, resection provided greater disease-free survival, although both treatment modalities provided similar overall survival.
肝切除术是可切除结直肠癌肝转移（CRLM）患者的一线治疗方法，而射频消融（RFA）可用于因疾病范围、解剖位置不佳或合并症而无法切除的小 CRLM。然而，对于可切除的 CRLM 患者，RFA 治疗的长期结果尚不清楚。本研究旨在比较接受肝切除术或 RFA 治疗的可切除 CRLM 患者的复发率和预后。
回顾性分析 2010 年 11 月至 2015 年 12 月期间接受 RFA 或肝切除术的连续患者。采用倾向评分分析消除组间基线差异。比较接受肝切除术和 RFA 治疗的患者的生存率和复发率。
采用 1:2 比例的倾向评分匹配后，RFA 组 46 例，切除术组 92 例。两组总生存率相似，但切除术组无疾病生存率更高（中位，22 个月比 14 个月）。而在肿瘤直径≤3cm 的患者中，两组无疾病生存率相似（中位，24 个月比 21 个月）。与切除术组相比，RFA 组肝内复发率更高（34.8%比 12.0%），无复发生存期更短。两组局部和全身复发率和无复发生存期差异无统计学意义。无病生存率差与 RFA、T4、肿瘤直径>3cm 和淋巴结阳性有关。
在技术上可切除的 CRLM 患者中，切除术提供了更好的无病生存率，尽管两种治疗方法的总生存率相似。
