Radiofrequency ablation vs. hepatectomy for liver metastases from gastrointestinal stromal tumors

Yi Zeng; Yudong Ling; Xiaojiang Chen; Chao Ding; Yukai Jin; Shoucheng Feng; Zhenchong Chen; Jianrong Guo; Haibo Qiu

doi:10.3892/ol.2024.14266

Radiofrequency ablation vs. hepatectomy for liver metastases from gastrointestinal stromal tumors

Oncol Lett. 2024 Jan 31;27(3):133. doi: 10.3892/ol.2024.14266. eCollection 2024 Mar.

Authors

Yi Zeng¹, Yudong Ling¹, Xiaojiang Chen¹, Chao Ding¹, Yukai Jin¹, Shoucheng Feng¹, Zhenchong Chen¹, Jianrong Guo¹, Haibo Qiu¹

Affiliation

¹ Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China.

Abstract

For patients with gastrointestinal stromal tumors (GISTs) and liver metastases, there is still debate about whether radiofrequency ablation (RFA) or hepatectomy is preferable. The present study aimed to compare the clinical outcomes of RFA with hepatectomy in patients with GISTs and liver metastases. The present retrospective study consisted of a cohort of 43 patients who had been diagnosed with liver metastases from GISTs between January 2010 and December 2022. The study included 18 patients who received RFA combined with tyrosine kinase inhibitor (TKI) therapy (RFA group) and 25 patients who underwent hepatectomy combined with TKI therapy (hepatectomy group). For the patients with liver metastases, the progression-free survival (PFS) rates at 1, 3 and 5 years were 66.5, 38.2 and 33.9%, respectively. Notably, patients in the hepatectomy group exhibited significantly improved PFS times compared with those in the RFA group (median PFS, 42.7 months vs. 14.3 months; P=0.034). Furthermore, the time to imatinib treatment failure (TTF) was notably improved in the hepatectomy group compared with that in the RFA group, and this difference was statistically significant (median TTF, 71.1 vs. 38.0 months; P=0.041). However, the overall survival (OS) times of patients who received RFA and those who had hepatectomy did not differ significantly (median OS, not reached vs. not reached, P=0.120). There was no statistically significant distinction in PFS and TTF between patients who underwent hepatectomy combined with postoperative TKI and those who underwent hepatectomy combined with perioperative TKI (median PFS, 29.5 vs. not reached; P=0.520; median TTF, 66.4 months vs. 71.1 months; P=0.430). The univariate and multivariate analyses consistently identified the sole prognostic factor affecting PFS as hepatectomy combined with TKI therapy (hazard ratio, 0.379; 95% CI, 0.159-0.899; P=0.028). In conclusion, hepatectomy combined with TKI therapy improved prognosis for patients with liver metastases to a greater extent than RFA combined with TKI therapy. For this type of patient, hepatectomy may be a preferable option.

Keywords: GIST; RFA; TKI; hepatectomy; liver metastasis.

Grants and funding

This project was supported by the Natural Science Foundation of Guangdong Province (grant no. 2022A1515012347) and the Beijing CSCO-ROCHE Research Fund (grant no. Y-2019Roche-157).