Cancer Management and Research (Oct 2018)
Radiofrequency ablation with systemic chemotherapy in the treatment of colorectal cancer liver metastasis: a 10-year single-center study
Abstract
Shuangyan Ou,1 Ruocai Xu,1 Ke Li,1 Yong Chen,1 Yi Kong,1 Hanchun Liu,1 Jianliang Li,1 Yongzhong Ouyang,2 Xiaoping Yu3 1Department of Hepatobiliary and Pancreatic Medicine, Hunan Cancer Hospital, Changsha City, Hunan Province, China; 2Department of Gastroduodenal Surgery, Hunan Provincial Cancer Hospital, Changsha City, Hunan Province, China; 3Department of Radiology, Hunan Cancer Hospital, Changsha City, Hunan Province, China Objective: To 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). Methods: This 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. Results: A 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. Conclusion: RFA 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. Keywords: radiofrequency assay, systemic chemotherapy, liver metastasis, colorectal cancer, ultrasound, survival
