| Background and OBJECTIVE:At present,the incidence of colorectal cancer is increasing year by year in China.The high incidence and mortality of colorectal cancer seriously affect human health,and liver is the organ most prone to distant metastasis of colorectal cancer.Radiofrequency ablation（RFA）,a minimally invasive treatment for tumor ablation through the thermal effect of electric current,is becoming a new choice for patients with colorectal cancer and liver metastasis.The purpose of this study was to investigate the clinical efficacy of radiofrequency ablation in the treatment of liver metastasis of colorectal cancer,and to analyze the influencing factors of Overallsurvival（OS）and progression-free Survival（PFS）after radiofrequency ablation.To provide reference for the treatment of patients with liver metastasis of colorectal cancer.Methods:A retrospective study was conducted to follow up 105 patients with liver metastasis from colorectal cancer admitted to China-Japan Union Hospital of Jilin University from January 2014 to October 2020,including 72 males and 33 females,with a median age of 60 years（38-79 years）and an average of 59.3years.All patients were divided into two groups according to whether they underwent radiofrequency ablation or not,41 patients in the radiofrequency ablation group and 64 patients in the non-radiofrequency ablation group（control group）.Radiofrequency group: all received percutaneous radiofrequency ablation guided by B-ultrasound.In this group,there were 16 patients with single liver metastasis and 25 patients with multiple liver metastasis,and the average number of tumors was 3.07±2.47.The median maximum diameter of liver tumors per patient was 2.7cm,with a mean of3.03±1.65（0.8-8）cm.Control group: none of the patients received radiofrequency ablation,including 14 patients with single metastasis and 50 patients with multiple metastasis,with an average number of tumors of3.32±1.90.The median maximum diameter of liver tumors per patient was4.1cm,with a mean of 4.24±1.39 cm.The variables were classified in an orderly manner,and the segmentation points were selected to group the variables appropriately.SPSS22.0 software was used for data analysis and processing.The age,gender,number of liver tumors and maximum diameter of liver tumors of patients in the RF group and the control group were statistically compared and analyzed to determine whether there was a statistical difference between the two groups.Subgroup analysis was performed for patients in the RF group.Kaplan-meier univariate analysis was used for survival curve analysis,and log-rank test was used to screen out influencing factors with P <0.05.The screened factors were input into Cox regression analysis model for multivariate survival analysis,and the independent influencing factors of PFS and OS were finally obtained.Results:The median PFS was 6.8 months in the RF group and 4.5 months in the control group,（P =0.00）.The median OS in the RF group was 25.8 months.The median OS in control group was 19.3 months,（P =0.00）.Subgroup analysis was performed on the RF group,and kaplan-Meier single factor analysis method was used to analyze the survival curve of each variable.The influencing factors of PFS were as follows: number of liver tumors（number >3,PFS=4.2;Number ≤3,PFS=10.6,P =0.032）,maximum diameter of liver tumor（diameter ≥5cm,PFS=1.5;Diameter 3-5cm,PFS=6.8;Diameter < 3cm,PFS=11.5,p=0.014）,presence of extrahepatic metastasis(presence of extrahepatic metastasis PFS=4.0 months;No extrahepatic metastasis（PFS=11.5,P =0.003）,whether to perform hepatectomy（PFS=14.0 months for hepatectomy;PFS=5.0,P =0.0047）without hepatectomy.The influencing factors of OS were as follows: number of liver tumors（number > 3 OS=20.6;Number ≤3,OS=39.0 months,P=0.026）,maximum diameter of liver tumor（diameter ≥5cm,OS=13.0;Diameter 3-5cm,OS=39.0;Diameter < 3cm,OS=25.8,P =0.038）,whether there was extrahepatic metastasis(no extrahepatic metastasis,OS=46.8;Extrahepatic metastasis（OS=20.6,P=0.010）and liver metastasis（OS=54.4;Simultaneous liver metastasis OS=20.0,P =0.012）.The above influencing factors were input into Cox regression analysis model for multivariate survival analysis.The final influencing factors of PFS were the maximum tumor diameter and the existence of extrahepatic metastasis,while the influencing factors of OS were the maximum tumor diameter and the nature of liver metastasis（simultaneous and heterochronous）.In this study,there were few RFA-related complications,only 3 patients（7.3%）had fever within 2 days after surgery,8 patients（19.5%）had pain at the puncture site,and 4 patients had mild abnormal liver function,all of which were improved after symptomatic treatment.Conclusion:1.RAF technology has the advantages of less trauma,repeatability,high safety and fewer complications,and is an effective adjuvant therapy for liver metastasis of colorectal cancer.2.RFA has a good effect on patients with small diameter（specific size）and small number（specific size）of liver metastases. |
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