To compare the clinical efficacy of hepatectomy and microwave ablation (MWA) for colorectal cancer liver metastases (CRLM) and clarify the clinical value and limitations of MWA in high-risk CRLM lesions.
Approach:
Study Design: Retrospective analysis of 98 patients with CRLM treated between July 2008 and February 2019, comparing outcomes between 31 patients who underwent hepatectomy and 67 who received MWA.
Subgroup Analysis: 105 CRLM lesions were categorized into high-risk (n = 36) and non-high-risk (n = 69) locations for further analysis.
Key Findings:
Patients treated with hepatectomy achieved significantly better recurrence-free survival (RFS) and overall survival (OS) than those treated with MWA.
In the MWA cohort, lesions <3 cm in diameter could be completely ablated regardless of anatomical location.
For tumors >3 cm, the complete ablation rate was significantly lower in high-risk lesions than in non-high-risk lesions.
Tumor diameter was identified as an independent risk factor for incomplete ablation.
Interpretation:
Limitations:
The study is retrospective, which may introduce selection bias.
The sample size for the hepatectomy group was relatively small.
Conclusion:
Hepatectomy is more effective than MWA for CRLM, especially for high-risk lesions larger than 3 cm.
