Surgical Resection Versus Microwave Ablation for Colorectal Liver Oligometastases: A Multicenter Cohort Study of 1027 Patients.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-04-17 DOI:10.1007/s12029-025-01222-y

Bin Li, Lei Li, He Ren

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引用次数: 0

Abstract

Background: The choice between surgical resection (SR) and microwave ablation (MWA) as first-line treatments that prolong survival duration for colorectal liver oligometastases (CRLOM) remains controversial.

Objective: This study aimed to compare survival outcomes, therapeutic parameters, and safety between SR and MWA in patients with CRLOM.

Methods: From January 2012 to December 2022, we identified 1027 eligible patients with CRLOM who underwent either SR (n = 464) or MWA (n = 563) as hepatic local-region treatment. The cumulative 1-, 3-, 5-, and 8-year overall survival (OS) and progression-free survival (PFS) rates between the two modalities were compared using the Kaplan-Meier method with the log-rank test. The propensity score matching (PSM) method was used to improve the selective bias. Univariate and multivariate analyses of clinicopathological variables were conducted to identify risk factors affecting long-term survival.

Results: After PSM, all baseline variables were balanced between the SR (n = 393) and MWA groups (n = 393). After a median follow-up of 39.8 months, no significant differences in the long-term survival outcomes were observed between the two groups (median OS time, MWA: 70.6 months vs. SR: 83.2 months; P = 0.124; median PFS time, MWA: 18.5 months vs. SR: 22.3 months; P = 0.680). PSM-adjusted analyses revealed similar results. The presence of 3-5 intrahepatic nodules (hazards ratio [HR] 1.65; 95% CI 1.31-2.06; P < 0.001) and SR (HR 1.28; 95% CI 1.11-1.69; P = 0.028) were independent prognostic risk factors for OS. A significant interaction effect of therapeutic modality and age, pathological differentiation, diameter, and number was observed (P = 0.039, 0.004, 0.031, and 0.032).

Conclusions: MWA offers comparable long-term survival benefits to SR for patients with CRLOM.

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手术切除与微波消融治疗结直肠癌肝少转移：1027例患者的多中心队列研究。

背景：外科切除（SR）和微波消融（MWA）作为延长结肠直肠肝寡转移瘤（CRLOM）生存期的一线治疗方法的选择仍然存在争议。目的：本研究旨在比较SR和MWA治疗CRLOM患者的生存结局、治疗参数和安全性。方法：从2012年1月至2022年12月，我们确定了1027例符合条件的CRLOM患者，他们接受了SR （n = 464）或MWA （n = 563）作为肝脏局部治疗。使用Kaplan-Meier方法和log-rank检验比较两种治疗方式的累积1年、3年、5年和8年总生存期（OS）和无进展生存期（PFS）。采用倾向得分匹配（PSM）方法改善选择性偏差。对临床病理变量进行单因素和多因素分析，以确定影响长期生存的危险因素。结果：PSM后，所有基线变量在SR组（n = 393）和MWA组（n = 393）之间平衡。中位随访39.8个月后，两组长期生存结果无显著差异(中位OS时间，MWA: 70.6个月vs. SR: 83.2个月；P = 0.124；中位PFS时间，MWA: 18.5个月vs. SR: 22.3个月；P = 0.680)。经psm调整后的分析也显示出类似的结果。存在3-5个肝内结节(危险比[HR] 1.65；95% ci 1.31-2.06；P < 0.001)和SR (HR 1.28；95% ci 1.11-1.69；P = 0.028)是OS的独立预后危险因素。治疗方式与年龄、病理分型、直径、数量的交互作用显著（P = 0.039、0.004、0.031、0.032）。结论：MWA为CRLOM患者提供了与SR相当的长期生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.