Chen Yizhen, Huang Yurun, Xu Linwei, Wu Jia, Han Fang, Jiang Hang, Zheng Pengwen, Xu Dong, Zhang Yuhua
Department of Hepatobiliary and Pancreatic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, China.
Zhejiang Chinese Medical University, Hangzhou 310053, China.
Cancers (Basel). 2022 Oct 28;14(21):5320. doi: 10.3390/cancers14215320.
Background: Most colorectal liver metastases (CRLM) are not candidates for liver resection. Radiofrequency ablation (RFA) plays a key role in selected CRLM patients. Neoadjuvant chemotherapy (NAC) followed by liver resection has been widely used for resectable CRLM. Whether NAC followed by radiofrequency ablation (RFA) can achieve a similar prognosis to NAC followed by hepatectomy remains is unclear. The present study aimed to provide a new treatment modality for CRLM patients. Methods: This comparative retrospective research selected CRLM patients from 2009 to 2022. They were divided into NAC + RFA group and NAC + hepatectomy group. The propensity score matching (PSM) was used to reduce bias. We used multivariate cox proportional hazards regression analysis to explore independent factors affecting prognosis. The primary study endpoint was the difference in the progression-free survival (PFS) between the two groups. Results: A total of 190 locally curable CRLM patients were in line with the inclusion criteria. A slight bias was detected in the comparison of basic clinical characteristics between the two groups. RFA showed a significant advantage in the length of hospital stay (median; 2 days vs. 7 days; p < 0.001). The 1- and 3-year PFS in the liver resection and the RFA groups was 57.4% vs. 86.9% (p < 0.001) and 38.8% vs. 55.3% (p = 0.035), respectively. The 1-year and 3-year OS in the liver resection and RFA groups was 100% vs. 96.7% (p = 0.191) and 73.8% vs. 73.6% (p = 0.660), respectively. Conclusions: NAC followed by RFA has rapid postoperative recovery, fewer complications, and better prognosis.
大多数结直肠癌肝转移（CRLM）患者不适合进行肝切除术。射频消融（RFA）在部分CRLM患者中发挥着关键作用。新辅助化疗（NAC）后行肝切除术已广泛应用于可切除的CRLM患者。NAC后行射频消融（RFA）是否能获得与NAC后行肝切除术相似的预后尚不清楚。本研究旨在为CRLM患者提供一种新的治疗方式。方法：本比较性回顾性研究选取了2009年至2022年的CRLM患者。他们被分为NAC + RFA组和NAC + 肝切除组。采用倾向评分匹配（PSM）来减少偏差。我们使用多变量Cox比例风险回归分析来探索影响预后的独立因素。主要研究终点是两组之间无进展生存期（PFS）的差异。结果：共有190例局部可治愈的CRLM患者符合纳入标准。两组基本临床特征比较存在轻微偏差。RFA在住院时间方面显示出显著优势（中位数；2天对7天；p < 0.001）。肝切除组和RFA组的1年和3年PFS分别为57.4%对86.9%（p < 0.001）和38.8%对55.3%（p = 0.035）。肝切除组和RFA组的1年和3年总生存期（OS）分别为100%对96.7%（p = 0.191）和73.8%对73.6%（p = 0.660）。结论：NAC后行RFA术后恢复快、并发症少且预后更好。
