Effect of colorectal resection combined with intraoperative radiofrequency ablation in treating colorectal cancer with liver metastasis and analysis of its prognosis.

Objective: To explore the efficacy and safety of colorectal resection combined with intraoperative radiofrequency ablation (RFA) in the treatment of colorectal cancer (CRC) with liver metastasis.

Methods: The clinical data of 106 CRC patients with liver metastasis were retrospectively analyzed. There were 53 cases treated with CRC resection combined with RFA (RFA group) and 53 cases treated with surgical resection of CRC and liver metastasis (surgery group). The clinicopathological features, and perioperative and postoperative complications were compared between the two groups, and the patient's survival and tumor recurrence were recorded via follow-up. Moreover, the risk factors for survival and recurrence in patients were analyzed via univariate and multivariate Cox regression analyses.

Results: In the RFA group, the amount of intraoperative blood loss and the number of cases of blood transfusion were significantly smaller than those in the surgery group, and the postoperative hospital stay was obviously shorter than that in the surgery group. In the surgery group, the median recurrence-free survival was 16.4 months, and the 1-, 2- and 3-year tumor-free survival rates were 56.6%, 37.7% and 15.1%, respectively. In the RFA group, the median recurrence-free survival was 10.5 months, and the 1-, 2- and 3-year tumor-free survival rates were 41.5%, 17.0% and 7.5%, respectively. Log-rank test showed no statistically significant difference in overall survival between the two groups (p=0.151), but found in tumor-free survival (p=0.028). Besides, the results of univariate and multivariate analyses showed that the number of metastases, the maximum diameter of liver metastases and the N stage of the primary tumor were independent influencing factors for the postoperative overall survival of patients. The number of metastases >1, N1-2 stage of primary tumor and combined RFA were independent risk factors for tumor recurrence in patients.

Conclusions: Compared with resection of CRC and liver metastasis, colorectal resection combined with RFA can significantly reduce the intraoperative blood loss and shorten the hospital stay, with a comparable long-term survival, but the tumor recurrence rate is higher than that in patients with resection.