Periprocedural risk factors for incomplete radiofrequency ablation of liver metastases from colorectal cancer: a single-center retrospective analysis

• Published in: International journal of hyperthermia Vol. 38; no. 1; pp. 985 - 994
• Main Authors: Fan, Hongjie, Wang, Xiaoyan, Qu, Jiali, Lu, Wei, Pang, Zhenzhu, Shao, Tingting, Xia, Jingya, Wang, Huiyang, Li, Guangyao, Zhang, Yanhua, Sun, Jihong, Yang, Xiaoming
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.01.2021; Taylor & Francis Group
• Subjects: Catheter Ablation; Colorectal Neoplasms; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; magnetic resonance imaging; progression-free survival; Radiofrequency Ablation; Retrospective Studies; Risk Factors; Treatment Outcome; magnetic resonance imaging; Colorectal neoplasms; radiofrequency ablation; progression-free survival
• ISSN: 0265-6736; 1464-5157
• DOI: 10.1080/02656736.2021.1942564

To explore independent risk factors for incomplete radiofrequency ablation (iRFA) of colorectal cancer liver metastases (CRLM) and evaluate adverse outcomes following iRFA. Magnetic resonance imaging data of CRLM patients who received percutaneous RFA were randomized into training (70%) and validation set 1 (30%) data sets. An independent validation set 2 was derived from computed tomography scans. Uni- and multivariate analyses identified independent risk factors for iRFA. Area under the curve (AUC) values were used to evaluate the predictive model performance. Risk points were assigned to independent predictors, and iRFA was predicted according to the total risk score. Kaplan-Meier curves were used to assess new intrahepatic metastases (NIHM), unablated tumor progression, and overall survival (OS). Multivariate regression determined as independent iRFA risk factors perivascular tumor location, subcapsular tumor location, tumor size ≥20 mm, and minimal ablative margin ≤5 mm. The AUC values of the model in the training set, validation set 1, and validation set 2 were 0.867, 0.772, and 0.820, respectively. The respective AUC values of the total risk score were 0.864, 0.768, and 0.817. During the 6-year follow-up, the cumulative OS was significantly shorter in the iRFA than in the complete RFA group, and NIHM (hazard ratio [HR] = 2.79; 95% confidence interval [CI]: 1.725, 4.513) and unablated tumor progression (HR = 3.473; 95% CI: 1.506, 8.007) were more severe. Perivascular tumor location, subcapsular tumor location, tumor size ≥20 mm, and minimal ablative margin ≤5 mm were independent risk factors for iRFA. iRFA may be a potential predictor of NIHM, unablated tumor progression, and OS.