Radiofrequency ablation versus resection for resectable liver metastases of gastrointestinal stromal tumours: Results from three national centres in China.

Objective: The aim of the present study was to compare outcomes after curative intent radiofrequency ablation and resection in patients with resectable liver metastases of Gastrointestinal Stromal Tumours (GISTs) after pre-operative tyrosine kinase inhibitor (TKI) treatment.
Methods: We retrospectively analysed data from 25 patients diagnosed with resectable liver metastases from GISTs who received pre-operative TKI treatment, who received radiofrequency ablation or resection and post-operative TKI treatment, and who were admitted to 3 institutions from January 2009 to December 2017.
Results: Ten patients (10/25, 40.00%) underwent RFA combined with post-operative TKI treatment, and 15 (15/25, 60.00%) patients were treated with hepatic resection combined with post-operative TKI treatment. There were fewer post-operative complications (10.00% vs. 53.33%, P = 0.04) and shorter length of stay (4 vs. 9 days, P = 0.00) in the RFA group. After a median follow-up of 26 months, the 1-, 3-, and 5-year survival rates were 100.00%, 75.00%, 55.00%, respectively. The RFA group had a lower median PFS (P = 0.007, mPFS: 9 months versus 29 months), but overall survival was not influenced by the treatment modality compared with the resection group (P = 0.413, mOS: 47 months versus not reached).Hepatic resection combined with post-operative TKI treatment was the only prognostic factor for PFS in univariate analysis (HR = 0.071, 95% CI: 0.007-0.759, P = 0.029).
Conclusions: For patients with resectable liver metastases from GISTs after receiving pre-operative TKI treatment, compared with resection, ablation seemed to be associated with shorter progression-free survival, but RFA offered comparable overall survival, and the post- procedure morbidity and lengths of stay were significantly lower. With complete ablation of the targeted tumours, our results suggest that RFA is an acceptable option in selected patients.
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