Radiofrequency ablation with systemic chemotherapy in the treatment of colorectal cancer liver metastasis: a 10-year single-center study

Abstract

ObjectiveTo retrospectively evaluate the long-term efficacy and safety of radiofrequency ablation (RFA) with systemic chemotherapy (CT) in treatment of solitary liver metastasis after surgery for colorectal cancer (CRC).MethodsThis single-center study was conducted at the Hunan Provincial Cancer Hospital from June 2006 to December 2015 with median follow-up time of 26 months. Percutaneous ultrasound-guided RFA was carried out on eligible patients with solitary liver metastasis after surgery for CRC. After a week, ablation status was confirmed by MRI. Post MRI, all patients received systemic CT with or without molecular-targeted therapy. Survival rate was evaluated and survival curve was constructed with Kaplan–Meier analysis. Log-rank test and Cox regression model were used for univariate and multivariate analysis, respectively, to determine the independent prognostic factors for survival rate.ResultsA total of 109 eligible patients (mean age, 53.84±11.71; mean tumor mass diameter, 3.4+2.01 cm) were enrolled in this 10-year study. After RFA, 95 patients achieved complete ablation, and 14 patients achieved partial ablation, with median ablation time of 26 minutes (range: 12–120 minutes). The median survival time required for achieving complete and partial ablation was 56.0 and 19.0 months, respectively (P<.01). After RFA and adjuvant systemic CT, the 1-, 3-, and 5-year survival rates were 92.3%, 50.7%, and 41.6%, respectively, with the median (mean) survival time of 39.0 (56.5) months. Age was the only significant independent prognostic factor with better survival rate observed in patients aged ≥50 years than those aged <50 years (P<0.05). The incidence of complications was minimal (1.8%) with only two cases: one biliary fistula and one liver hemorrhage.ConclusionRFA combination with systemic CT was safe; it showed long-term efficacy in patients with solitary liver metastasis after surgery for CRC and can be a preferred treatment.

Prognostic Factors of Radiofrequency Ablation plus Systemic Chemotherapy for Unresectable Colorectal Cancer with Liver Metastasis

“…Several previous studies of patients with CRC liver metastasis have reported improved survival (37–45 months) when systemic chemotherapy was combined with local interventions, but outcomes were different in the literature review. Shuangyan et al retrospectively evaluated the long-term survival of 109 CRC patients with liver metastasis treated by RFA plus systemic chemotherapy in China and demonstrated survival outcomes similar to those reported here: (1) median survival of 39 months and (2) 1-year, 3-year, and 5-year survival rates of 92.3%; 50.7%, and 41.6%, respectively [ 14 ]. Rues et al reported the results of a randomized phase II study (EORTC 40004) characterizing RFA combined with systemic chemotherapy for unresectable colorectal liver metastasis.…”

Three-year Survival Rate after Radiofrequency Ablation for Surgically Resectable Colorectal Lung Metastases: A Prospective Multicenter Study

“…affected by the synergistic effect of chemotherapy and RFA, which has been demonstrated in animal experiments (31,32) and in RFA for CRC liver metastases (33).…”

Is percutaneous destruction of a solitary liver colorectal metastasis as effective as a resection?

“…Available data on the prognostic impact of the CLM hemi-liver location is insufficient, despite many small series reporting poorer prognoses. [25][26][27] The mechanisms of metastatic cancer cell dissemination and implantation are unclear, and no indisputable conclusions can be drawn based on the current knowledge.…”