Outcomes of ultrasound-guided percutaneous ablation of >5 versus ≤ 5 colorectal liver metastases: a propensity score matching study.

IF 3 3区医学 Q2 ONCOLOGY

International Journal of Hyperthermia Pub Date : 2025-12-01 Epub Date: 2025-04-21 DOI:10.1080/02656736.2025.2488128

Jingwen Zhou, Si Qin, Rui Cui, Yao Chen, Yimin Wang, Guangjian Liu

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引用次数: 0

Abstract

Objectives: To investigate the effectiveness and safety of microwave ablation (MWA) in patients with 1-5 colorectal liver metastases (CRLM) versus those with 6-9 CRLM.

Methods: Data from patients with 1-9 CRLM, who underwent ultrasound (US)-guided percutaneous MWA between January 2018 and May 2023, were retrospectively analyzed. Propensity score matching (PSM) at a ratio of 1:2 was used to balance potential bias between the groups.

Results: Data from 264 patients were included in the analysis. After PSM, there were 43 and 75 patients in the CRLM >5 and ≤5 groups, respectively. Even with higher tumor burden and technical difficulty, there was no statistical difference in the local tumor progression (LTP)-free survival (LTPFS) between the groups (p > 0.05). Patients with an ablation margin (AM) ≤5 mm exhibited a significantly higher rate of LTP than those with AM >5 mm in both groups(p < 0.05). Patients with 6-9 CRLM experienced a higher incidence of intrahepatic recurrence (iHR) (p = 0.041) and shorter progression-free survival (PFS) at any site (p < 0.05). CRLM > 5 is an independent risk factor for poor PFS (p = 0.008). The minor complication rate was lower in the CRLM ≤ 5 group (p < 0.05) and the major complication rate showed no difference (p > 0.05).

Conclusions: When the number of CRLM was limited to 9, single-session MWA was feasible and safe for radical local treatment. An AM >5 mm was critical for local tumor control. Compared with patients with 1-5 CRLM, those with 6-9 CRLM experienced inferior PFS at any site, which mainly lies in more iHR.

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超声引导下经皮消融bbb50 vs≤5结直肠肝转移的结果：倾向评分匹配研究

目的：探讨微波消融（MWA）治疗1 ~ 5例结直肠肝转移（CRLM）患者与6 ~ 9例结直肠肝转移（CRLM）患者的有效性和安全性。方法：回顾性分析2018年1月至2023年5月期间接受超声引导下经皮MWA治疗的1-9例CRLM患者的数据。采用1:2的倾向评分匹配（PSM）来平衡组间的潜在偏倚。结果：264例患者的数据被纳入分析。经PSM后，CRLM bb0 5组43例，≤5组75例。尽管肿瘤负担和技术难度较高，但两组局部肿瘤进展（LTP）无生存（LTPFS）差异无统计学意义（p < 0.05）。两组消融边缘≤5mm的患者LTP发生率均显著高于消融边缘≤5mm的患者（p p = 0.041），且任何部位的无进展生存期（PFS）均较短(p 5是PFS差的独立危险因素（p = 0.008）。CRLM≤5组轻微并发症发生率较低（p < 0.05）。结论：当CRLM数量限制在9个时，单次MWA对于根治性局部治疗是可行且安全的。AM bbb50 mm对局部肿瘤控制至关重要。与1-5级CRLM患者相比，6-9级CRLM患者各部位PFS均较差，主要表现为iHR较多。

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