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Combining Radiofrequency Ablation with Hepatic Resection for Liver-Only Colorectal Metastases: A Propensity-Score Based Analysis of Long-Term Outcomes

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Combining liver resection (LR) with radiofrequency ablation (RFA) is nowadays an accepted option for treating colorectal liver metastases (CRLMs), but the number of lesions ablated is regularly described as a recurrence risk factor. In this study, we report our experience and determine the impact of RFA on long-term outcomes.

Method

This is a retrospective study including patients undergoing LR with or without RFA for CRLM. All variables influencing disease-free survival (DFS) and disease-specific survival (DSS) were examined through a Cox regression analysis before and after propensity-score matching (PSM).

Results

Among the 128 patients included, 71 (55.5%) underwent LR alone and 57 (44.5%) underwent LR+RFA. With univariate analysis, LR+RFA showed a significantly worse DFS than LR alone (p = 0.028), which was not confirmed after PSM (p = 0.064). Thermal ablation did not influence DSS before or after matching (p = 0.282 and p = 0.189). When analyzing the subgroups of patients according to number of RFAs performed, no difference in long-term outcomes was observed (after PSM: p = 0.192 for DFS and p = 0.624 for DSS). Analysis of site of recurrence revealed that neither performing an RFA (p = 0.893) nor the number of lesions ablated (p = 0.093, p = 0.550, and p = 0.087 for 1, 2, and ≥ 2 RFAs) were associated with an increased risk of liver-only relapse.

Discussion

In the setting of a parenchymal sparing strategy, combining RFA with LR is safe in terms of oncological outcomes. Tumor burden, rather than RFA performed, independently influences risk of recurrence and patient survival.

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Authors and Affiliations

  1. Department of Visceral and Digestive Surgery, University Hospital of Strasbourg, Strasbourg, France

    Fabio Giannone MD, Aurélien Grollemund MD, Zineb Cherkaoui MD & Patrick Pessaux MD, PhD

  2. Institut de Recherche sur les Maladies Virales et Hépatiques, U1110, Université de Strasbourg, Strasbourg, France

    Fabio Giannone MD, Catherine Schuster PhD & Patrick Pessaux MD, PhD

  3. Institute of Image-Guided Surgery, Institut Hospitalo-Universitaire (IHU), Strasbourg, France

    Fabio Giannone MD, Zineb Cherkaoui MD & Patrick Pessaux MD, PhD

  4. Liver Transplant and Surgery Department, Trousseau Hospital, Tours, France

    Emanuele Felli MD, PhD

  5. Department of Radiology, University Hospital of Strasbourg, Strasbourg, France

    Theo Mayer MD

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Giannone, F., Grollemund, A., Felli, E. et al. Combining Radiofrequency Ablation with Hepatic Resection for Liver-Only Colorectal Metastases: A Propensity-Score Based Analysis of Long-Term Outcomes. Ann Surg Oncol 30, 4856–4866 (2023). https://doi.org/10.1245/s10434-023-13530-3

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