Non-response to preoperative chemotherapy is a contraindication to hepatectomy plus radiofrequency ablation in patients with colorectal liver metastases

作者：Mao, Rui; Zhao, Jian-Jun; Zhao, Hong^*; Zhang, Ye-Fan; Bi, Xin-Yu; Li, Zhi-Yu; Zhou, Jian-Guo; Wu, Xiao-Long; Xiao, Chen; Cai, Jian-Qiang^*

来源：Oncotarget, 2017, 8(43): 75151-75161.

DOI：10.18632/oncotarget.20647

• colorectal liver metastases
• hepatectomy
• radiofrequency ablation
• preoperative chemotherapy
• response

The long-term outcome of 228 patients with colorectal liver metastases (CRLM) who underwent preoperative chemotherapy followed by hepatectomy +/- RFA were retrospectively analyzed. Stratified by chemotherapy response, patients were divided into responding (n= 129) and non-responding groups (n= 99). Patients who underwent hepatectomy-RFA had a greater number of metastases (median of 4 vs. 2, p= 0.000), a higher incidence of bilobar involvement (66.7% vs. 49.1%, p= 0.014) and longer chemotherapy cycles (median of 6 vs. 4, p= 0.000). In the responding group, the median overall survival (OS) and recurrence free survival (RFS) of hepatectomy-RFA and the hepatectomy alone subgroups were comparable (38.6 months vs. 43.2 months, p= 0.824; 8.2 months vs. 11.4 months, p= 0.623). In the non-responding group, the median OS and RFS of patients treated with hepatectomy-RFA were significantly shorter (18.5 months vs. 34.2 months, p= 0.000; 5.1 months vs. 5.9 months, p= 0.002). RFA was identified as the unfavorable independent factor for both OS (HR= 3.60, 95% CI= 1.81-7.16, p= 0.039) and RFS (HR= 1.70, 95% CI= 1.00-2.86, p= 0.048) in non-responsive patients. Local recurrence rate after hepatectomy-RFA was higher in the non-responding group (48.1% vs. 23.6%, p= 0.018). Non-response to preoperative chemotherapy may be a contraindication to hepatectomy-RFA in patients with CRLM.

• 出版日期2017-9-26
• 单位中国医学科学院北京协和医院