Long-term outcome for colorectal liver metastases: combining hepatectomy with intraoperative ultrasound guided open microwave ablation versus hepatectomy alone

• Published in: International journal of hyperthermia 2021-01, Vol.38 (1), p.372-381
• Main Authors: Dai, Yunzhu, Zhang, Yuanping, He, Wei, Peng, Chuan, Qiu, Jiliang, Zheng, Nan, Li, Huifang, Liu, Wenwu, Zheng, Yun, Li, Binkui, Yuan, Yunfei, Zou, Ruhai
• Format: Article
• Language: English
• Subjects: colorectal liver metastases; Intraoperative ultrasound; long-term outcome; open microwave ablation; ultrasound guided ablation
• ISSN: 0265-6736; 1464-5157
• DOI: 10.1080/02656736.2021.1892835

To compare the long-term outcome of combining hepatectomy with intraoperative ultrasound (IOUS)-guided open microwave ablation (MWA) versus hepatectomy alone in patients with colorectal cancer liver metastases (CRLM). A retrospective analysis of patients with CRLM who underwent hepatectomy alone (HT group; 380 patients) or hepatectomy combined with IOUS-guided open MWA (HT + MWA group; 57 patients) from April 2002 to September 2018 was conducted at our center. A propensity score-matched (PSM) analysis was used to reduce data bias between the two groups. The overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups after matching. Although intrahepatic recurrence was more frequent in the HT + MWA group in both the whole and matched cohort, the two groups exhibited similar rates of extrahepatic recurrence as well as concomitant intra- and extrahepatic recurrence. A higher number of CRLM (>3), larger maximum-size and absence of response to induction chemotherapy were independent risk factors for OS. The oncological outcomes of hepatectomy combined with intraoperative open ablation was not significantly different to hepatectomy alone and should be considered as a safe and fair option for patients with difficultly resectable CRLM.