Percutaneous ablation of liver metastases from colorectal cancer: a comparison between the outcomes of ultrasound guidance and CT guidance using propensity score matching

Abstract

To compare the effectiveness and outcomes between percutaneous ablation guided by ultrasound (US) and CT in colorectal liver oligometastases (CLOM). Methods:We included patients with CLOM treated with percutaneous ablation from January, 2008 to January, 2021 in this observational study. Only patient lesions visualized on both CT and US images were further analyzed, and patients' initial ablation treatments were used for analysis.Patients were divided into US-guided group and CT-guided group based on procedure equipment. We used the Kaplan-Meier method to estimate local tumor progression (LTP)-free survival after propensity score matching (PSM). The LTP-free survival and treatment related outcomes were compared between them. Results:The PSM identified 116 patients from each group, with 269 and 238 lesions in the US-guided and CT-guided group, respectively. The US-guided ablation had shorter average procedure time and lower cost compared with CT-guided ablation (27.54±12.06 min vs. 32.70±13.88 min, p=0.003; $2175.13±618.17 vs. $2455.49±710.25, p=0.002). For patients with age > 60 years, the cumulative LTP rate at 1-year was lower in the US-guided group than those in the CT-guided group (17.8% vs. 25.1%, p=0.038). For patients with perivascular liver lesions, the cumulative LTP rate at 1-year was lower in the US-guided group (14.4% vs. 28.2%, p=0.040). Conclusion:With patients whose age is > 60 years or who have perivascular liver lesions, US-guided ablation is better than CT-guided ablation with shorter treatment time and lower cost when patients were feasible for both ablation methods.