01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Radiofrequency ablation for liver metastases in patients with gastric cancer as an alternative to hepatic resection
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Background
Methods
Patients
Statistical analysis
RFA procedure
Follow-up
Results
Characteristics
|
HR (
N = 7) n (%)
|
RFA (
N = 11) n (%)
|
P* value
|
---|---|---|---|
Sex
|
|||
Male
|
5 (71.4)
|
10 (90.9)
|
0.280
|
Female
|
2 (28.6)
|
1 (9.1)
|
|
Age
|
|||
<60
|
2 (28.6)
|
4 (36.4)
|
0.732
|
≥60
|
5 (71.4)
|
7 (63.6)
|
|
Comorbidity
|
|||
No
|
5 (71.4)
|
6 (54.5)
|
0.474
|
Yes
|
2 (28.6)
|
5 (45.5)
|
|
ECOG PS
|
|||
0
|
7 (100)
|
4 (36.4)
|
0.026
|
1
|
0 (0)
|
5 (45.5)
|
|
2
|
0 (0)
|
2 (18.2)
|
|
Tumor location
|
|||
Upper 1/3
|
0 (0)
|
1 (9.1)
|
0.434
|
Middle 1/3
|
2 (28.6)
|
1 (9.1)
|
|
Lower 1/3
|
5 (71.4)
|
9 (81.8)
|
|
Differentation
|
|||
Differentiated
|
4 (51.7)
|
7 (63.6)
|
0.783
|
Undifferentiated
|
3 (42.9)
|
4 (36.4)
|
|
Leuren
|
|||
Intestinal
|
3 (42.9)
|
6 (54.5)
|
0.629
|
Diffuse&Mixed
|
4 (51.7)
|
5 (45.5)
|
|
Primary Tumor size
|
|||
<3 cm
|
1 (14.3)
|
1 (9.1)
|
0.829
|
≥3 cm
|
6 (85.7)
|
10 (90.9)
|
|
Lymphatic invasion
|
|||
LI (−)
|
3 (42.9)
|
1 (9.1)
|
0.093
|
LI (+)
|
4 (57.1)
|
10 (90.9)
|
|
Vascular invasion
|
|||
VI (−)
|
4 (57.1)
|
8 (72.7)
|
0.494
|
VI (+)
|
3 (42.9)
|
3 (27.3)
|
|
Perineural invasion
|
|||
NI (−)
|
4 (57.1)
|
8 (72.7)
|
0.494
|
NI (+)
|
3 (42.9)
|
3 (27.3)
|
|
T stage
|
|||
T1-2
|
1 (14.3)
|
5 (45.5)
|
0.171
|
T3-4
|
6 (85.7)
|
6 (54.5)
|
|
N stage
|
|||
N0
|
2 (28.6)
|
1 (9.1)
|
0.280
|
N1-3
|
5 (71.4)
|
10 (90.9)
|
|
AJCC 7
th stage
|
|||
Stage 1–2
|
3 (42.9)
|
5 (45.5)
|
0.914
|
Stage 3-4
|
4 (57.1)
|
6 (54.5)
|
|
Chemotherapy
|
|||
CTx (−)
|
1 (14.3)
|
1 (9.1)
|
0.732
|
CTx (+)
|
6 (85.7)
|
10 (90.1)
|
|
Number of metastatic Tumor
|
|||
Single
|
5 (71.4)
|
8 (72.7)
|
0.952
|
Multiple
|
2 (28.6)
|
3 (27.3)
|
|
Size of metastatic Tumor
|
|||
<3cm
|
4 (42.9)
|
6 (54.5)
|
0.914
|
≥3cm
|
3 (57.1)
|
5 (45.5)
|
|
Lobar distribution
|
|||
Unilobar
|
6 (85.7)
|
10 (90.9)
|
0.732
|
Bilobar
|
1 (14.3)
|
1 (9.1)
|
|
Pre-treatment
|
|||
Chemotherapy
|
|||
CTx (−)
|
7 (100)
|
7 (63.6)
|
0.070
|
CTx (+)
|
0 (0)
|
4 (36.4)
|
|
Post-treatment Chemotherapy
|
|||
CTx (−)
|
1 (14.3)
|
7 (63.6)
|
0.040
|
CTx (+)
|
6 (85.7)
|
4 (36.4)
|
|
Complication
|
|||
No
|
5 (71.4)
|
11 (100)
|
0.060
|
Yes
|
2 (28.6)
|
0 (0)
|
Characteristics
|
5-YSR (%)
|
Univariate
P value*
|
HR
|
Multivariate
P value
|
---|---|---|---|---|
Sex
|
0.000
|
0.951
|
||
Male
|
68.2
|
Ref
|
||
Female
|
0
|
408620.765
|
||
Age
|
0.624
|
|||
<60
|
41.7
|
|||
≥60
|
65.5
|
|||
Differentiation
|
0.034
|
0.191
|
||
Differentiated
|
85.7
|
Ref
4.685
|
||
Undifferentiated
|
25.7
|
|||
Primary tumor size
|
0.853
|
|||
<3 cm
|
66.7
|
|||
≥3 cm
|
58.1
|
|||
Lymphatic invasion
|
0.822
|
|||
LI (−)
|
66.7
|
|||
LI (+)
|
60.2
|
|||
Vascular invasion
|
0.369
|
|||
VI (−)
|
58.2
|
|||
VI (+)
|
50.0
|
|||
Perineural invasion
|
0.959
|
|||
PI (−)
|
67.5
|
|||
PI (+)
|
55.6
|
|||
T stage
|
0.266
|
|||
T1-2
|
40.0
|
|||
T3-4
|
73.3
|
|||
N stage
|
0.448
|
|||
N0
|
50.0
|
|||
N1-3
|
62.2
|
|||
AJCC 7
th stage
|
0.779
|
|||
Stage 1–2
|
66.7
|
|||
Stage 3-4
|
56.3
|
|||
Number of metastatic
Tumor
|
0.237
|
|||
Single
|
58.6
|
|||
Multiple
|
66.7
|
|||
Size of metastatic
Tumor
|
0.427
|
|||
<3 cm
|
64.8
|
|||
≥3 cm
|
58.3
|
|||
Lobar distribution
|
0.821
|
|||
Unilobar
|
66.8
|
|||
Bilobar
|
50.0
|
|||
Type of treatment
|
0.671
|
|||
Hepatic resection
|
68.6
|
|||
RFA
|
47.6
|
Characteristics
|
5-DFS (%)
|
Univariate
P value
|
HR
|
Multivariate
P value
|
---|---|---|---|---|
Sex
|
0.266
|
|||
Male
|
54.2
|
|||
Female
|
0
|
|||
Age
|
0.596
|
|||
<60
|
33.3
|
|||
≥60
|
56.3
|
|||
Differentiation
|
0.932
|
|||
Differentiated
|
50.0
|
|||
Undifferentiated
|
41.7
|
|||
Primary tumor size
|
0.731
|
|||
<3 cm
|
33.3
|
|||
≥3 cm
|
50.3
|
|||
Lymphatic invasion
|
0.731
|
|||
LI (−)
|
33.3
|
|||
LI (+)
|
50.3
|
|||
Vascular invasion
|
0.049
|
0.061
|
||
VI (−)
|
30.3
|
Ref 0.128
|
||
VI (+)
|
80.0
|
|||
Perineural invasion
|
0.858
|
|||
PI (−)
|
50.5
|
|||
PI (+)
|
40.0
|
|||
T stage
|
0.297
|
|||
T1-2
|
33.3
|
|||
T3-4
|
55.6
|
|||
N stage
|
0.761
|
|||
N0
|
50.0
|
|||
N1-3
|
46.4
|
|||
AJCC 7
th stage
|
0.227
|
|||
Stage 1–2
|
28.6
|
|||
Stage 3-4
|
63.5
|
|||
Number of metastatic
Tumor
|
0.059
|
|||
Single
|
30.3
|
|||
Multiple
|
80.0
|
|||
Size of metastatic
Tumor
|
0.702
|
|||
<3 cm
|
40.0
|
|||
≥3 cm
|
62.5
|
|||
Lobar distribution
|
0.683
|
|||
Unilobar
|
46.4
|
|||
Bilobar
|
50.0
|
|||
Type of treatment
|
0.073
|
0.072
|
||
Hepatic resecction
|
80.0
|
Ref
7.171
|
||
RFA
|
30.3
|
RFA treatment
Clinical data
|
Liver metastasis
|
RFA
|
Recur
|
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Case
|
Comorbidity
|
PS
|
No
|
Lobar
|
Chronicity
|
Size (cm)
|
CTx after RFA
|
Number of initial RFA
|
Recur
|
Pattern
|
Tx after recur
|
OS (mon)
|
DFS (mon)
|
Survival
a
|
1
|
No
|
0
|
1
|
Uni
|
Meta
|
2.6
|
Yes
|
2
|
Yes
|
Liver
|
RFA
|
69.1
|
10.3
|
Death
|
2
|
Yes
|
1
|
1
|
Uni
|
Meta
|
3.7
|
Yes
|
1
|
Yes
|
Liver
|
CTx
|
20.7
|
0.8
|
Death
|
3
|
No
|
0
|
5
|
Bi
|
Meta
|
1
|
No
|
2
|
Yes
|
Liver
|
None
|
40.5
|
11.4
|
Death
|
4
|
No
|
1
|
2
|
Uni
|
Syn
|
2
|
Yes
|
1
|
No
|
79.6
|
42.3
|
Alive
|
||
5
|
Yes
|
1
|
1
|
Uni
|
Meta
|
1.7
|
No
|
1
|
Yes
|
Liver
|
RFA
|
21.8
|
4.7
|
Death
|
6
|
No
|
0
|
1
|
Uni
|
Meta
|
3.3
|
Yes
|
1
|
No
|
22.9
|
22.6
|
Alive
|
||
7
|
Yes
|
1
|
1
|
Uni
|
Meta
|
0.5
|
No
|
1
|
Yes
|
Virchow Node
|
CTx
|
12.8
|
9.4
|
Alive
|
8
|
Yes
|
0
|
1
|
Uni
|
Meta
|
1.5
|
No
|
1
|
Yes
|
Lung
|
None
|
25.1
|
8.9
|
Alive
|
9
|
Yes
|
2
|
1
|
Uni
|
Meta
|
4.2
|
No
|
1
|
Yes
|
Liver
|
None
|
20.0
|
7.9
|
Alive
|
10
|
Yes
|
1
|
1
|
Uni
|
Meta
|
3.7
|
No
|
1
|
No
|
3.6
|
3.3
|
Alive
|
||
11
|
No
|
2
|
2
|
Uni
|
Meta
|
3.2
|
NO
|
1
|
No
|
15.3
|
14.4
|
Alive
|