Is percutaneous destruction of a solitary liver colorectal metastasis as effective as a resection?

Ugo Marchese; Héloïse Seux; Jonathan Garnier; Jacques Ewald; Gilles Piana; Bernard Lelong; Cécile De Chaisemartin; Hélène Meillat; Jean-Robert Delpero; Olivier Turrini

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자료유형: 학술저널

저자정보: Ugo Marchese (Institut Paoli-Calmettes) Héloïse Seux (Institut Paoli-Calmettes) Jonathan Garnier (Institut Paoli-Calmettes) Jacques Ewald (Institut Paoli-Calmettes) Gilles Piana (Institut Paoli-Calmettes) Bernard Lelong (Institut Paoli-Calmettes) Cécile De Chaisemartin (Institut Paoli-Calmettes) Hélène Meillat (Institut Paoli-Calmettes) Jean-Robert Delpero (Institut Paoli-Calmettes) Olivier Turrini (Aix-Marseille University)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제2호

발행연도: 2021.5

수록면: 198 - 205 (8page)

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Backgrounds/Aims: Surgical resection remains the gold standard in the treatment of colorectal liver metastasis. However, when a patient presents with a deep solitary colorectal liver metastasis (S-CLM), the balance between the hepatic volume sacrificed and the S-CLM volume is sometimes clearly unappropriated. Thus, alternatives to surgery, such as operative and percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA), have been developed. This study aimed to identify the prognostic factors affecting survival of patients with S-CLM who undergo curative-intent liver resection or local destruction (RFA or MWA). Methods: We retrospectively identified 211 patients with synchronous or metachronous S-CLM who underwent either surgical resection (n=182) or local destruction (RFA or MWA; n=29) according to the S-CLM size, location, and surrounding Glissonian structures. Results: Patients who underwent RFA or MWA had S-CLM of a smaller size than those who underwent resection (mean 19.7 vs. 37.3 mm, p＜.01). The 1-, 3-, and 5-year overall survival (OS) rates were 97.4%, 84.9%, and 74.9%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 77.9%, 47%, and 38.9%, respectively. S-CLM located in the left liver (p=.04), S-CLM KRAS mutation (p＜.01), and extra-hepatic recurrence (p＜.01) were identified as independent poor risk factors for overall survival (OS); the OS and DFS were comparable in patients with surgical procedure or percutaneous MWA. Conclusions: In eligible S-CLM cases, percutaneous MWA seems to be as oncologically efficient as surgical resection and should be include in the decision-tree for treatment strategies.

#Hepatic resection #Liver metastases #Solitary #Microwave ablation #Percutaneous

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