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A Single-Center Retrospective Analysis of Periprocedural Variables Affecting Local Tumor Progression after Radiofrequency Ablation of Colorectal Cancer Liver Metastases

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Abstract
Background: Local tumor progression (LTP) is associated with poorer survival in patients undergoing radiofrequency ablation (RFA) for colorectal liver metastasis (CLM). An algorithmic strategy to predict LTP may help in selection of patients who would benefit most from RFA for CLM.

Purpose: To estimate local tumor progression-free survival (LTPFS) following RFA of CLM and develop an algorithmic strategy based on clinical variables.

Materials and Methods: In this retrospective study, between March 2000 and December 2014, patients who underwent percutaneous RFA for CLM were randomly split into development (60%) and internal validation (40%) data sets. Kaplan-Meier method was used to estimate LTPFS and overall survival (OS) rates. Independent factors affecting LTPFS in the development data set were investigated by using multivariable Cox proportional hazard regression analysis. Risk scores were assigned to the risk factors and applied to the validation data set.

Results: A total of 365 patients (mean age, 60 years 6 11 [standard deviation]; 259 men) with 512 CLMs were evaluated. LTPFS and OS rates were 85% and 92% at 1 year, 73% and 41% at 5 years, 72% and 30% at 10 years, and 72% and 28% at 15 years, respectively. Independent risk factors for LTP included tumor size of 2 cm or greater (hazard ratio [HR], 3.8; 95% CI: 2.3, 6.2; P < .001), subcapsular tumor location (HR, 1.9; 95% CI: 1.1, 3.1; P = .02), and minimal ablative margin of 5 mm or less (HR, 11.7; 95% CI: 4.7, 29.2; P < .001). A prediction model that used the risk factors had areas under the curve of 0.89, 0.92, and 0.90 at 1, 5, and 10 years, respectively, and it showed significantly better areas under the curve when compared with the model using the minimal ablative margin of 5 mm or less alone.

Conclusion: Radiofrequency ablation provided long-term control of colorectal liver metastases. Although minimal ablative margin of 5 mm or less was the most dominant factor, the multifactorial approach including tumor size and subcapsular location better predicted local tumor progression-free survival. (C) RSNA, 2020
Author(s)
김진형김표년박성호박지홍양슬기이명지전승용최현경한기창
Issued Date
2021
Type
Article
Keyword
Colorectal Neoplasms - pathologyDisease ProgressionFemaleHumansLiver Neoplasms - diagnostic imagingLiver Neoplasms - secondaryLiver Neoplasms - surgeryMaleMiddle AgedRadiofrequency Ablation - methodsRetrospective StudiesX-Ray ComputedTreatment Outcome
DOI
10.1148/radiol.2020200109
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7749
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_pubmed_primary_33170105&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,A%20Single-Center%20Retrospective%20Analysis%20of%20Periprocedural%20Variables%20Affecting%20Local%20Tumor%20Progression%20after%20Radiofrequency%20Ablation%20of%20Colorectal%20Cancer%20Liver%20Metastases&amp;offset=0&amp;pcAvailability=true
Publisher
RADIOLOGY
Location
미국
Language
영어
ISSN
0033-8419
Citation Volume
298
Citation Number
1
Citation Start Page
212
Citation End Page
218
Appears in Collections:
Medicine > Medicine
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