Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3300-3307
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3300
Hepatectomy vs radiofrequency ablation for colorectal liver metastasis: A propensity score analysis
Huisong Lee, Jin Seok Heo, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Seong Ho Choi, Dong Wook Choi
Huisong Lee, Jin Seok Heo, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Seong Ho Choi, Dong Wook Choi, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Author contributions: Heo JS is the guarantor of this entire study; all authors participated in the study design and data analysis, participated in drafting the article and gave final approval; Lee H, Kim HC, and Choi DW researched the literature; Heo JS, Lee H, Lee WY, Choi SH, and Choi DW performed the clinical studies; Lee H, Heo JS and Yun SH conducted statistical analyses; manuscript editing was carried out by all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jin Seok Heo, MD, PhD, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, South Korea. jsheo.md@gmail.com
Telephone: +82-10-99330262 Fax: +82-2-34106980
Received: August 19, 2014
Peer-review started: August 20, 2014
First decision: September 27, 2014
Revised: November 3, 2014
Accepted: December 8, 2014
Article in press: December 8, 2014
Published online: March 21, 2015
Processing time: 212 Days and 1.8 Hours
Abstract

AIM: To compare outcomes from radiofrequency ablation (RFA) and hepatectomy for treatment of colorectal liver metastasis (CRLM).

METHODS: From January 2000 to December 2009, 408 patients underwent curative intent treatment for CRLM. We excluded patients using the criteria: size of CRLM > 3 cm, number of CRLM ≥ 5, percutaneous RFA, follow-up period < 12 mo, double primary cancer, or treatment with both RFA and hepatectomy. We matched 51 patients who underwent RFA with 102 patients who underwent hepatectomy by propensity scores.

RESULTS: The median follow-up period was 45 mo (range, 12 mo to 158 mo). Hepatic recurrence was more frequent in the RFA than the hepatectomy group (P = 0.021) although extrahepatic recurrence curves were similar (P = 0.716). Survival curves of hepatectomy group were better than that of RFA for multiple, large (> 2 cm) CRLM (P = 0.034). However, survival curves were similar for single or small (≤ 2 cm) CRLM (P = 0.714, P = 0.740).

CONCLUSION: Hepatectomy is better than RFA for the treatment of CRLM. However, RFA might be suitable for selected patients with single, small (≤ 2 cm) CRLM.

Keywords: Colorectal neoplasm; Metastasis; Catheter ablation; Hepatectomy; Liver

Core tip: Previous studies reported that hepatectomy is better than radiofrequency ablation (RFA) to improve survival outcomes in the patients with colorectal liver metastasis (CRLM). However, there is still controversy that RFA is beneficial in selected patients. In this study, hepatectomy was better than RFA for the treatment of CRLM. However, RFA might be suitable for selected patients with single, small CRLM (≤ 2 cm).