Incomplete Radiofrequency Ablation in the Treatment of Colorectal Cancer Liver Metastasis: A Multicenter Prospective Cohort Study

Radiofrequency ablation (RFA) is a commonly used interventional method for treating colorectal cancer liver metastases (CLMs), with its efficacy influenced by tumor characteristics and intrahepatic distribution. The presence of incomplete RFA (iRFA) can result in poorer prognosis and may impede the effectiveness of targeted therapies or immunotherapy. Currently, there is a lack of multicenter prospective cohort studies and predictive models for iRFA. This study prospectively included CLM patients from four medical centers who underwent percutaneous RFA to develop and validate a predictive model for iRFA. All patients were followed up, with the occurrence of new intrahepatic metastases (NIHM) and overall survival (OS) assessed using the Kaplan-Meier method. We identified independent predictors of iRFA, including perivascular tumor location (odds ratio [OR] = 3.164), tumor size ≥ 20 mm (OR = 5.639), and minimal ablative margin (OR = 0.607). The area under the receiver operating characteristic curve (AUC) was 0.884 for the developmental cohort and 0.857 for the external validation cohort. Compared to the complete RFA group, patients in the iRFA group had a higher incidence of NIHM and shorter OS. However, broader external validation and the inclusion of more variables for comprehensive analysis and balance are still needed.