Radiofrequency ablation versus partial hepatectomy with or without radiofrequency ablation for colorectal cancer liver metastases

Background Colorectal cancer (CRC) is a common malignancy. 20–40% of bowel cancers are accompanied by liver metastases, and liver failure due to liver metastases is the most common cause of death in bowel cancer patients. Radiofrequency ablation (RFA) and partial hepatectomy (PH) are two commonly used treatments for colorectal cancer liver metastases. The aim of this paper is to compare the relapse -free survival (RFS) and overall survival (OS) of intrahepatic lesions between these two treatment modalities. Methods We retrospectively analysed the data of patients who underwent surgery for CRLM at the First Affiliated Hospital of Xi'an Jiaotong University from 2017 to 2024 and were diagnosed with CRLM by postoperative pathology. We collected the clinicopathological characteristics of the patients in the RFA group and the patients in the PH group with or without RFA, and compared the RFS and OS of intrahepatic foci of these two treatment modalities using the log - rank test. The patients were also scored by CRS, and the differences in postoperative RFS and OS between patients with high CRS scores (≥ 3) and those with low CRS scores (< 3) were compared using the log - rank test. Finally, univariate analysis and multifactorial Cox regression survival analysis were performed to identify independent risk factors affecting prognosis. Results A total of 109 CRLM patients were included, 50 of whom underwent RFA and 59 underwent PH. The RFS of the RFA Group (median RFS: 14 months) was significantly shorter than that of the PH group (median RFS: 23 months) (P = 0.013). While there was no significant difference in OS between the two groups (RFA Group median OS: undefined, PH group median OS: 62 months) (P = 0.109). The RFS of the CRS high - scoring group (median RFS: 13 months) was slightly shorter than that of the CRS low - score group (median RFS: 17 months) (P = 0.349), and there was no significant difference. The median OS of the CRS high - score group vs the CRS low - score group was undefined (P: 0.711), and there was no significant difference between the two groups. For RFS, the independent factors were surgical method and CEA. For OS, there were no independent factors. Conclusions The RFS and the OS of the PH group vs the RFA Group suggested that the patients with PH with or without RFA for CRLM may have better short - term control than the RFA group. The RFS and the OS of the CRS high - score group vs the CRS low - score group suggested that the CRS score might not accurately predict the RFS and the OS of CRLM patients after PH or RFA.