The Results of the Combine Treatment of Patients with Liver Bilobar Metastases from Colorectal Cancer Using Radiofrequency Ablation

Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide. The mortality from CRC remains very high. The main cause of such a high mortality is a disseminate process with the appearance of distant metastases. In this regard, the treatment of metastatic lesions is recognized as an important trend in modern oncology. The program of study included 176 patients with colorectal cancer after primary tumor removal with the malignant progression-multiple (more than 4) bilobar liver metastases. The research was organized in Samara Regional Oncology Centre from 2001 to 2014. By the treatment method, patients were divided into two groups. Main group got the combined (chemotherapy + radiofrequency ablation (RFA)) treatment ( = 98). In control group, only chemotherapy was applied ( = 78). One-, two-, and three-year OS were 73.5, 25.1, and 7.2% in the main group and 39.6, 6.3, and 2.1% in the control group. The RFA application allowed us to reach the index of 4-year survival 1.8% in the main group, while we received only 2.1 of 3-year survival in the control group. The OS median reached 18 months in the main group and 11 months in the control group. So, the OS curves in two comparing groups were significantly different according to statistics (log-rank test 3.77, = 0.000). The application of RFA in combination with chemotherapy in the treatment of bilobar metastasis colorectal cancer allows to improve the performance of disease-free survival and overall survival significantly, compared with the group of patients who received only chemotherapy.

Aggressive Graphic/Surgical R0 Resection and Jejunal Interposition with Preservation of Mesojejunal Autonomic Nerves in Patients with Stage IV Esophagogastric Junction Adenocarcinoma: A Report of 3 Cases

“…In the field of gastric cancer, hepatectomy for liver metastases may be acceptable if the patient has a small number of metastases and no factors indicating unresectability [33][34][35]. The usefulness of RFA has been documented for liver metastasis of colorectal cancer [36][37][38][39], and RFA may be an alternative to hepatectomy in patients with gastric cancer [40][41][42][43]. RFA seemed to be effective in our patient (Case 3).…”

Evidence on percutaneous radiofrequency and microwave ablation for liver metastases over the last decade

“…Yang et al conducted a study including CRLM and reported that RFA with chemotherapy prolonged the median OS (29 vs. 12 months, p = 0.002) compared to chemotherapy alone [ 43 ]. A retrospective study by Kaganov et al included 176 patients with colorectal cancer with 824 liver metastases; 98 and 78 of whom underwent RFA with chemotherapy and chemotherapy-alone, respectively [ 44 ]. In the RFA with chemotherapy and chemotherapy-alone groups, the 1-, 2-, and 3-year OS were 73.5% and 39.6%, 25.1% and 6.3%, and 7.2% and 2.1%, respectively, and the median OS was 18 and 11 months, respectively [ 44 ].…”

“…A retrospective study by Kaganov et al included 176 patients with colorectal cancer with 824 liver metastases; 98 and 78 of whom underwent RFA with chemotherapy and chemotherapy-alone, respectively [ 44 ]. In the RFA with chemotherapy and chemotherapy-alone groups, the 1-, 2-, and 3-year OS were 73.5% and 39.6%, 25.1% and 6.3%, and 7.2% and 2.1%, respectively, and the median OS was 18 and 11 months, respectively [ 44 ]. The OS was significantly better in the RFA with chemotherapy group than in the chemotherapy-alone group [ 44 ].…”

“…In the RFA with chemotherapy and chemotherapy-alone groups, the 1-, 2-, and 3-year OS were 73.5% and 39.6%, 25.1% and 6.3%, and 7.2% and 2.1%, respectively, and the median OS was 18 and 11 months, respectively [ 44 ]. The OS was significantly better in the RFA with chemotherapy group than in the chemotherapy-alone group [ 44 ]. Ruers et al reported the results of a randomized prospective comparative trial of RFA with chemotherapy and chemotherapy alone for CRLM in 119 patients [ 45 ].…”