Abstract

Objective

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).

Method

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.

Results

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.

Conclusion

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.

中文翻译：

---

大肠肝转移的长期结果：肝切除术与术中超声引导的开放微波消融相结合单独进行肝切除术

摘要

客观的

为了比较在结直肠癌肝转移（CRLM）患者中肝切除术与术中超声（IOUS）引导的开放式微波消融（MWA）与单纯肝切除术相结合的长期结果。

方法

从2002年4月至2018年9月，对仅接受肝切除术（HT组; 380例）或肝切除联合IOUS指导的开放式MWA（HT + MWA组; 57例）的CRLM患者进行回顾性分析。倾向得分匹配（PSM）分析用于减少两组之间的数据偏倚。

结果

匹配后两组之间的总生存期（OS）和无病生存期（DFS）没有显着差异。尽管HT + MWA组在整个队列和匹配队列中肝内复发均较频繁，但两组肝外复发率以及肝内和肝外复发率均相似。较高的CRLM（> 3），较大的最大肿瘤大小和对诱导化疗无反应是OS的独立危险因素。

结论

肝切除术联合术中开放消融的肿瘤学结局与单纯肝切除术无显着差异，对于难以切除的CRLM患者，应将其视为安全，公平的选择。