Naïk Vietti Violi1, Rafael Duran1, Nicolas Demartines2, Christine Sempoux3, Boris Guiu1, Pierre E Bize1, Nathalie Sala3, Nermin Halkic2, Jean-Francois Knebel1,4, Alban Denys1. 1. a Department of Radiology and Interventional Radiology , Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland. 2. b Department of Surgery , Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland. 3. c Department of Pathology , Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland. 4. d Department of Clinical Neurosciences , Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland.
Abstract
PURPOSE: To compare local recurrence (LR) rate in patients with colorectal cancer liver metastasis (CRCLM) after surgical wedge resection (WR) or radiofrequency ablation (RFA) and to investigate predictive factors of LR. MATERIALS AND METHODS: This single-centre, retrospective, institutional review board-approved study including 43 consecutive patients with 121 metastases treated by WR and 60 patients with 110 metastases treated by RFA between 2007 and 2014 with 23 and 18.5 months of follow-up, respectively. Demographics and tumour characteristics were compared using the unpaired t-test and chi-square test. Predictive factors for LR (lesion size, depth, relation to hepatic vessels, intervention, margin status) were investigated in uni- and multivariate analyses. RESULTS: Patient and CRCLM characteristics were similar in both groups. Mean lesion size and depth in the WR and RFA groups were 18 mm and 15 mm (p = 0.03), and 19 mm and 26 mm (p < 0.001), respectively. LR showed a trend towards difference in favour of RFA (19% and 10% in the WR and RFA groups, respectively, p = 0.06). Positive margins and lesion depth were predictive factors of LR in the WR group (p = 0.03 and p = 0.02, respectively, on uni- and multivariable analyses). Lesion depth and proximity to a vein increased the risk of positive margins on pathology after WR (p = 0.04 and p < 0.001, respectively). Our analysis did not identify any predictive factors of LR following RFA. CONCLUSION: Our study showed a trend towards a lower LR rate with RFA compared to WR. Lesions located deep in the liver and/or close to large vessels are at high risk of LR following WR, while curative treatment can be obtained with RFA.
PURPOSE: To compare local recurrence (LR) rate in patients with colorectal cancer liver metastasis (CRCLM) after surgical wedge resection (WR) or radiofrequency ablation (RFA) and to investigate predictive factors of LR. MATERIALS AND METHODS: This single-centre, retrospective, institutional review board-approved study including 43 consecutive patients with 121 metastases treated by WR and 60 patients with 110 metastases treated by RFA between 2007 and 2014 with 23 and 18.5 months of follow-up, respectively. Demographics and tumour characteristics were compared using the unpaired t-test and chi-square test. Predictive factors for LR (lesion size, depth, relation to hepatic vessels, intervention, margin status) were investigated in uni- and multivariate analyses. RESULTS:Patient and CRCLM characteristics were similar in both groups. Mean lesion size and depth in the WR and RFA groups were 18 mm and 15 mm (p = 0.03), and 19 mm and 26 mm (p < 0.001), respectively. LR showed a trend towards difference in favour of RFA (19% and 10% in the WR and RFA groups, respectively, p = 0.06). Positive margins and lesion depth were predictive factors of LR in the WR group (p = 0.03 and p = 0.02, respectively, on uni- and multivariable analyses). Lesion depth and proximity to a vein increased the risk of positive margins on pathology after WR (p = 0.04 and p < 0.001, respectively). Our analysis did not identify any predictive factors of LR following RFA. CONCLUSION: Our study showed a trend towards a lower LR rate with RFA compared to WR. Lesions located deep in the liver and/or close to large vessels are at high risk of LR following WR, while curative treatment can be obtained with RFA.
Authors: Robbert S Puijk; Madelon Dijkstra; Bente A T van den Bemd; Alette H Ruarus; Sanne Nieuwenhuizen; Bart Geboers; Florentine E F Timmer; Evelien A C Schouten; Jan J J de Vries; Bram B van der Meijs; Karin Nielsen; Rutger-Jan Swijnenburg; M Petrousjka van den Tol; Kathelijn S Versteeg; Birgit I Lissenberg-Witte; Hester J Scheffer; Martijn R Meijerink Journal: Cardiovasc Intervent Radiol Date: 2022-05-18 Impact factor: 2.797