Combined ablation and resection (CARe) for resectable colorectal cancer liver Metastases-A propensity score matching study

被引：7
作者：
Liu, Ming [1 ]
Wang, Yanyan [1 ]
Wang, Kun [1 ]
Bao, Quan [1 ]
Wang, Hongwei [1 ]
Jin, Kemin [1 ]
Liu, Wei [1 ]
Yan, Xiaoluan [1 ]
Xing, Baocai [1 ,2 ]
机构：
[1] Peking Univ Canc Hosp & Inst, Dept Hepatobiliary pancreat Surg 1, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing, Beijing, Peoples R China
[2] Peking Univ Canc Hosp, Dept Hepatobiliary pancreat Surgery 1, 52 Fucheng Rd, Beijing, Peoples R China
来源：
EJSO | 2023年 / 49卷 / 09期
关键词：
Colorectal liver metastases; Ablation; Liver resection; Prognosis; INTRAOPERATIVE RADIOFREQUENCY ABLATION; PARENCHYMAL SPARING SURGERY; LONG-TERM OUTCOMES; HEPATECTOMY; TUMOR; MANAGEMENT;
D O I：
10.1016/j.ejso.2023.05.006
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Background: The efficacy of combining ablation and resection (CARe) in treating unresectable colorectal cancer liver metastases (CRLM) was well established. This study aimed to investigate the surgical and oncological outcomes of CARe strategy focusing on initially resectable CRLM. Patients and methods: A total of 971 patients with resectable CRLM from a retrospective database of 1414 CRLM patients were enrolled, including 120 in the CARe group and 851 in the hepatectomy alone group. Short- and long-term outcomes were compared between groups using propensity score matching analysis.Results: After propensity score matching, 96 matched pairs of patients from each group were included. General characteristics of primary tumour and liver metastases were not statistically different between the CARe group and hepatectomy alone group. Disease-free survival (p = 0.257), intrahepatic recurrencefree survival (p = 0.329), and overall survival (p = 0.358) were similar between the two groups. Patients in CARe group had significantly reduced rate of major hepatectomy (5.2% vs. 21.9%, p = 0.001), lower incidence of postoperative hepatic insufficiency (0.0% vs. 5.2%, p = 0.023), and shortened postoperative hospital stay (7 d vs. 8 d, p = 0.019). Multivariate analysis showed that surgical approach did not affect oncologic outcome; liver metastasis with diameter >3 cm was an independent prognostic factor for hepatic recurrence-free and disease-free survival, and RAS status and lymph node metastasis at the primary site were independent prognostic factors for overall survival.Conclusion: For patients with resectable CRLM, CARe may be a better treatment strategy than hepatectomy alone, as it could avoid major hepatectomy and get better surgical outcomes, while providing the similar oncologic results. (c) 2023 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
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页数：9
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