Brief Article
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World J Gastroenterol. Jan 14, 2014; 20(2): 525-531
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.525
Comparative analysis of radiofrequency ablation and resection for resectable colorectal liver metastases
Sanghwa Ko, Hongjae Jo, Seongpil Yun, Eunyoung Park, Suk Kim, Hyung-Il Seo
Sanghwa Ko, Hongjae Jo, Seongpil Yun, Eunyoung Park, Hyung-Il Seo, Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, South Korea
Suk Kim, Department of Radiology, Biomedical Research Institute, Pusan National University, Busan 602-739, South Korea
Author contributions: Ko S and Jo H contributed equally to this work; Seo HI designed the research; Jo H and Seo HI collected the data of surgical resection; Kim S collected the data of RFA; Yun S and Park E analyzed the data; Ko S wrote the manuscript.
Supported by Clinical research grant from Pusan, National University Hospital 2013; A 2-Year Research Grant of Pusan National University
Correspondence to: Hyung-Il Seo, MD, PhD, Department of Surgery, Biomedical Research Institute, Pusan National University, 305 Gudeok-Ro, Seo-Gu, Busan, 602-739, South Korea. seohi71@hanmail.net
Telephone: +82-51-2407238 Fax: +82-51-2401365
Received: August 23, 2013
Revised: October 25, 2013
Accepted: November 2, 2013
Published online: January 14, 2014
Processing time: 148 Days and 21.4 Hours
Abstract

AIM: To evaluate the therapeutic efficacy of radiofrequency ablation (RFA) for resectable colorectal liver metastases (CRLM) compared with that of resection.

METHODS: Between June 2004 and June 2009, we retrospectively analyzed 29 patients with resectable CRLMs; 17 patients underwent RFA, and 12 underwent hepatic resection. All of the patients were informed about the treatment modalities and were allowed to choose either of them. RFA including an intraoperative approach was performed by a radiologist; otherwise, hepatic resection was performed by a surgeon. Comparative analysis of the two groups was performed, including comparisons of gender, age, and clinical outcomes, such as primary tumor stage and survival rates.

RESULTS: The mean tumor size was significantly larger in the resection group (3.59 cm vs 2.02 cm, P < 0.01), and the 5-year overall survival (OS) rate for all patients was 44.7%. There was no difference in the 5-year OS rates between the RFA and resection groups (37.8% vs 66.7%). Univariate analysis indicated significantly lower 5-year OS rates for patients with a tumor size > 3 cm. The 5-year disease-free survival (DFS) rates were 17.6% and 22.2% in the RFA and resection groups, respectively (P = 0.119). Univariate analysis revealed that in cases of male gender, age > 65 years, T stage < IV, absence of lymphatic metastasis, and tumor size > 3 cm, RFA resulted in significantly inferior 5-year DFS rates compared with surgical resection.

CONCLUSION: Surgical resection revealed superior outcomes in the treatment of resectable CRLMs, particularly in cases with a hepatic tumor size > 3 cm.

Keywords: Colorectal neoplasm; Metastasis; Radiofrequency; Hepatectomy; Survival

Core tip: Colorectal liver metastasis is diagnosed in approximately 50% of patients with colorectal cancer. Surgical resection is the optimal treatment strategy. Alternative local treatment modalities can be adapted, and radiofrequency ablation (RFA) is widely accepted. We examined whether RFA is an appropriate alternative method to surgery for resectable colorectal liver metastases. This study retrospectively compared the therapeutic efficacy of RFA and compared it with that of surgical resection in a single institute.