Hepatectomy vs radiofrequency ablation for colorectal liver metastasis: a propensity score analysis

World J Gastroenterol. 2015 Mar 21;21(11):3300-7. doi: 10.3748/wjg.v21.i11.3300.

Abstract

Aim: To compare outcomes from radiofrequency ablation (RFA) and hepatectomy for treatment of colorectal liver metastasis (CRLM).

Methods: From January 2000 to December 2009, 408 patients underwent curative intent treatment for CRLM. We excluded patients using the criteria: size of CRLM > 3 cm, number of CRLM ≥ 5, percutaneous RFA, follow-up period < 12 mo, double primary cancer, or treatment with both RFA and hepatectomy. We matched 51 patients who underwent RFA with 102 patients who underwent hepatectomy by propensity scores.

Results: The median follow-up period was 45 mo (range, 12 mo to 158 mo). Hepatic recurrence was more frequent in the RFA than the hepatectomy group (P = 0.021) although extrahepatic recurrence curves were similar (P = 0.716). Survival curves of hepatectomy group were better than that of RFA for multiple, large (> 2 cm) CRLM (P = 0.034). However, survival curves were similar for single or small (≤ 2 cm) CRLM (P = 0.714, P = 0.740).

Conclusion: Hepatectomy is better than RFA for the treatment of CRLM. However, RFA might be suitable for selected patients with single, small (≤ 2 cm) CRLM.

Keywords: Catheter ablation; Colorectal neoplasm; Hepatectomy; Liver; Metastasis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Chi-Square Distribution
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Female
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Logistic Models
  • Male
  • Metastasectomy / adverse effects
  • Metastasectomy / methods*
  • Metastasectomy / mortality
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local
  • Patient Selection
  • Propensity Score
  • Proportional Hazards Models
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Burden