Effect of Radiofrequency ablation on prognosis of patients with gastric cancer with liver metastasis: A multicenter retrospective cohort study

Purpose The prognosis is still poor in gastric cancer with liver metastasis (GCLMs). Although radiofrequency ablation (RFA) has been applied in the treatment of GCLMs, it remains controversial. This study aimed to show the effect of RFA on the prognosis of patients with GCLMs. Materials and Methods We retrospectively evaluated 137 patients who underwent therapeutic gastrectomy and local treatment of liver metastases (RFA + gastrectomy, n = 30; gastrectomy + chemotherapy, n = 17; chemotherapy, n = 90) from 2008 to 2016, choosing telephone or outpatient follow-up, and the follow-up date was up to the death ofpatients or December 31, 2019, with the follow-up rate of 100%. Results In the observation group, the median survival was 10.5 months (CI 9.2 months ~ 19.5 months), with the 1-,2-and 3-year survival rates of 45.8%, 20.8% and 6.25%, respectively. In the control group, the median survival was 6.2 months (CI 5.4 ~ 8.2 months), with the 1-, 2-and 3-year survival rates of 23.9%, 5.63% and 2.11%, respectively. Univariate analysis showed that age, time of liver metastasis, lymph node metastasis, vascular metastasis, times of chemotherapy, number of liver metastasis, primary gastrectomy and RFA could affected the prognosis, but gender, site of liver metastasis, type of pathological differentiation and nerve infiltration could not. Multivariate analysis showed that age and gastrectomy were independent factors affecting the prognosis of GCLMs. After Propensity Score Matching, The mean age was 65.4 ± 9.3 years in the ≤ 3 chemotherapy cycles group and 62.4 ± 9.7 years in the > 3 cycles group (p = 0.632). The timing of metastasis showed good balance with 60% vs. 80% metachronous metastases in the two groups (p = 1.000). Conclusions Among patients with gastric cancer liver metastases, RFA combined with gastrectomy demonstrated improved median survival in both the original cohort and the propensity score-matched analysis.