Cancers
Outcomes of Combined Hepatectomy and Intraoperative Ablation for Multiple Colorectal Liver Metastases: A Single-Center Retrospective Study
By Tsukasa Aihara, Shinichi Ikuta, Takayoshi Nakajima and 4 others.
Abstract
Introduction
Radical hepatectomy is the standard curative treatment for colorectal liver metastases (CRLMs). However, extensive resection may be contraindicated in patients with insufficient liver reserve or anatomically complex disease. Although ablation therapy is generally not recommended as a primary curative modality in current guidelines, intraoperative ablation may facilitate parenchymal-sparing, curative-intent treatment in selected high-risk patients.
Methods
This retrospective cohort study included 118 patients who underwent curative-intent hepatectomy for multiple CRLM. Patients were categorized into hepatectomy-only (Hx) and hepatectomy plus intraoperative ablation (Hx + Abl) groups, and propensity score matching (PSM) generated 29 balanced pairs. Overall survival (OS) and hepatic progression-free survival (HPFS) were compared using a log-rank test. Cox regression identified predictors of OS, and receiver operating characteristic (ROC) analysis evaluated tumor size associated with local recurrence after ablation.