1. Resectable recurrent colorectal liver metastasis: can radiofrequency ablation replace repeated metastasectomy?
- Author
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Jianjun Zhao, Hong Zhao, Yefan Zhang, Xinyu Bi, Yue Han, Zhiyu Li, Rui Mao, and Jianqiang Cai
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Percutaneous ,Colorectal cancer ,Radiofrequency ablation ,medicine.medical_treatment ,030230 surgery ,law.invention ,Metastasis ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Progression-free survival ,Aged ,Retrospective Studies ,Radiofrequency Ablation ,business.industry ,Liver Neoplasms ,Metastasectomy ,General Medicine ,Middle Aged ,medicine.disease ,Ablation ,Surgery ,Treatment Outcome ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,medicine.symptom ,Colorectal Neoplasms ,business ,therapeutics - Abstract
Background Percutaneous radiofrequency ablation (RFA) is used as a first-line treatment for colorectal liver metastases that recur after first liver resection in our institution. We aim to evaluate its therapeutic efficacy compared to repeated surgical resection. Methods A retrospective review was performed in 104 patients treated with curative intent for resectable recurrent colorectal liver metastases. Results Sixty-one patients underwent RFA and 43 patients underwent surgery. The overall recurrence rates were 82% in the RFA group and 65.1% in the resection group (P = 0.05). The local recurrence rate on a lesion-basis was markedly higher after RFA than that after resection (16.7% versus 7.3%, P = 0.04). The difference remained significant in patients with a maximum lesion diameter >3 cm (24.5% versus 7.6%, P = 0.01). RFA treatment was independently associated with recurrence on multivariate analyses (P = 0.01). 69.7% of RFA patients and 42.6% of surgery patients with intrahepatic recurrence were amenable to repeated local treatment (P = 0.05), leading to the equivalent actuarial 3-year progression free survival rates (RFA: 29.1% versus Resection: 33.1%, P = 0.48) and 5-year overall survival rates in the two treatment groups (RFA: 33% versus Resection: 28.4%, P = 0.36). Conclusions Surgery remains the treatment of choice for resectable recurrence. RFA may offer similar benefit in selected patients.
- Published
- 2019