Korean J Gastroenterol.  2012 Mar;59(3):218-223. 10.4166/kjg.2012.59.3.218.

Comparison of Radiofrequency Ablation and Resection for Hepatic Metastasis from Colorectal Cancer

• Lee KH
• Kim HO
• Yoo CH
• Son BH
• Park YL
• Cho YK
• Kim H
• Han WK

• KMID: 1245206
• DOI: http://doi.org/10.4166/kjg.2012.59.3.218

Abstract

BACKGROUND/AIMS
Radiofrequency ablation (RFA) has been mostly used as a therapeutic alternative to hepatic resection for treating liver metastasis of colorectal cancer. The purpose of the present study was to determine whether there were differences in outcome between RFA and surgical resection in the treatment of colorectal cancer with liver metastases.
METHODS
We performed a retrospective analysis of 53 patients who underwent only hepatic resection or only RFA for colorectal liver metastases. Twenty-five patients who underwent hepatic resection were compared with 28 patients who underwent RFA for synchronous or metachronous liver metastases.
RESULTS
The median CEA level at the time of diagnosis of liver metastases was significantly higher in the resection group (14.2 ng/mL vs. 2.8 ng/mL, p=0.002). The median size of main liver metastases was significantly larger in the resection group (4.0 cm vs. 2.05 cm, p=0.002). There was no difference in the percentage of patients experiencing major complication (one patient in each group). The marginal recurrence rate was significantly higher in the RFA group (p=0.004). Disease-free and overall survival were longer in the resection group (p=0.008 and 0.017, respectively). In multivariate analysis, only the type of treatment was a factor associated with disease-free and overall survival (p=0.004 and 0.007, respectively).
CONCLUSIONS
Because of the high marginal recurrence rate, RFA shows an inferior outcome in comparison with surgical resection. Therefore, RFA should be considered for only selected patients with unresectable (by any means) disease or with high operative risk.

Keyword

Radiofrequency ablation; Hepatic resection; Colorectal cancer; Liver metastasis

MeSH Terms

Adult
Aged
Aged, 80 and over
*Catheter Ablation
Colorectal Neoplasms/*pathology
Female
Hepatectomy
Humans
Liver Neoplasms/mortality/secondary/*surgery
Male
Middle Aged
Neoplasm Recurrence, Local/pathology
Retrospective Studies
Survival Analysis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Disease-free (A) and overall survival (B) were longer in the resection group (p=0.008 and 0.017, respectively). RFA, radiofrequency ablation.

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