| Background and objectives:Colorectal cancer is the third most common malignant tumor globally.About more than 50%of patients would eventually develop liver metastases after radical resection.Surgical resection is generally regarded as the preferred treatment for patients with colorectal liver metastases(CRLM).However,surgical resection is a viable option in only approximately 20%-25%of CRLM patients.Nowadays,microwave ablation(MWA)has been used for the treatment of unresectable CRLM.The aim of this study was to compare the safety,efficacy and long-term outcome of two kinds of treatment methods,and evaluate the curative effect of two kinds of treatment methods,and then to guide the choice of treatment methods.Materials and Methods:This study retrospectively analyzed 106 consecutive CRLM patients who underwent MWA(microwave ablation group)and 89 consecutive CRLM patients who underwent surgical resection(operation group)from January 2010 to December 2012.The clinical datas including general,clinical data of primary colorectal tumor,colorectal cancer after radical operation of standardized chemotherapy,liver metastases,the clinical data of hepatic metastasis of colorectal cancer found from radical surgery time interval before treatment,laboratory examination indexes,relapse after treatment and treatment,the follow-up survival data including survival status,tumor status,overall survival and disease-free survival time.Because of the different ways of treatment,treatment is not exactly the same,treatment operation group included bleeding and blood transfusion,surgical and pathological data,local efficacy of surgery;MWA treatment include whether complete ablation,supplementary treatment or two treatment;and the two groups of patients postoperative serious complications,hospitalization time etc..We calculated the complication rate,local tumor progression(LTP),overall survival rate(OS),disease-free survival rate(DFS)by statistically analysis,and evaluated the safety,efficacy and long-term efficacy.Results:A total of 89 cases of surgical patients with surgical resection and microwave ablation group in 106 cases,in addition to detect liver metastasis colorectal cancer radical surgery average interval distance of(23.6±4.8 months vs.17.0±18.6 months,χ~2=4.409,P=0.038),the clinical data had no statistically significant difference between two groups before treatment.Major complications occurred in 12 patients in the operation group,the rates of major complications was 13.5%(12/89).3 cases(3.8%,3/89)died within 2 weeks after operation;MWA group included 3 cases of serious complications,severe complication rate was 2.8%(2.8/106);the two group of major complications rates had significant difference(χ~2=5.564,P=0.039),MWA group of postoperative major complications rate compared with surgery low group.Surgical resection of 89 cases of patients with postoperative resection of the pathological examination of all tumors were R0resection,complete resection rate was 100%(167/167).3 patients died within 2 weeks after operation,and the success rate was 97.2%(86/89).In the MWA group,208 of the 218tumors were completely ablated after the first MWA treatment,and the first complete ablation rate was 95.4%(208/218).Totally 7 patients with partial residual tumors achieved complete ablation after the addition of MWA for two times,and the success rate was 100%(106/106).The two group success rate had no significant difference(χ~2=3.564,P=0.059).After the end of follow-up,MWA group1,3 and 5 year disease-free survival rates were63.2%,33%and 11.3%;operation group 1,3 and 5 year disease-free survival rates were76.4%,36.7%and 10.3%,the disease-free survival rates of two groups had no significant difference(χ~2=3.352,P=0.047).The operation group after 1,3 and 5 years overall survival rates were 95.4%,60.3%and 41.4%;MWA group after 1,3 and 5 years in the overall survival rates were 91.5%,53.7%and 33.7%,the overall survival rate difference between the two groups was statistically significant(χ~2=3.352,P=0.047).In the subgroup analysis,the average survival time of the patients in the operation group was(30.6±21.5)months after operation.The average survival time of the patients in the MWA group was about(31.4±16.3)months after operation.No significant differences between the two groups was statistically significant(χ~2=0.048,P=0.827);WMA group after 1 years,3 years and 5years overall survival rate were 92.3%,63.1%,36.4%;operation group after 1 years,3years and 5 years overall survival rates were:95.4%,60.3%and 41.4%.The two groups were no statistically significant difference in overall survival(χ~2=0.455,P=0.500).Conclusion:In the treatment of CRLM after radical resection,surgical resection and MWA are effective treatments.Compared with surgical resection,the incidence of postoperative complications in MWA group is low and the safety is higher.The disease-free survival rate of MWA group was similar to operation group.The overall survival of patients in MWA group is shorter than operation group.MWA may be considered as an alternative treatment for patients with early liver metastasis after radical resection of colorectal cancer.For patients with liver metastases after radical resection of colorectal cancer,the overall survival time was comparable to that of percutaneous MWA and surgical resection.MWA may be considered as an alternative treatment for patients with liver metastases after radical resection of colorectal cancer. |
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