Comparison of the long-term results of microwave and radiofrequency ablation therapies for hepatocellular cancer and colorectal cancer liver metastases

Purpose: This study aimed to detect the overall and disease-free survival on both hepatocellular carcinoma (HCC) and colorectal carcinoma (CRC) patients whose hepatic lesions ablated with thermal ablation methods and to evaluate the local progression-free survival on liver lesions in the interventional radiology section of Hacettepe University Medicine Faculty, since 2007. Afterward, comparison among these survival values according to the variables of both patients and lesions was aimed. Materials and Methods: Colorectal (n=74) and hepatocellular carcinoma (n=67) patients with thermal ablation have been identified since January 2007. Patients who did not have curative ablation and whose follow-up was inadequate were excluded from the study. After the survival of the patients was determined by Kaplan-Meier analysis, Logrank analysis was applied for its significance. In addition, multivariate Cox-regression analysis was applied to determine the prominent among the variables. Chi-Square test was also used to determine the possible relationship between local tumor progression, residual and complication development, and other variables. Results: Both in patients with colorectal carcinoma metastasis and in patients with hepatocellular cancer, the effect of thermal ablation technique on Microwave or Radiofrequency ablation was not significant on overall survival and liver progression-free survival values (p>0,05). The presence of extrahepatic metastasis, mutant K-Ras oncogene and primary origin of metastasis significantly affected survival in CRC patients (p<0,05). The patient's "Child" score, AFP value, and the degree of differentiation of the tumor at the time of initial thermal ablation significantly affected the survival in HCC patients (p<0,05). There was no significant effect on survival between CRC patients whether or not they received neoadjuvant systemic chemotherapy when liver metastasis was first detected. In HCC patients, no significant difference was found between the predisposing factor and survival values. Conclusions: Thermal ablation techniques, either alone or in combination with chemotherapy, surgery or other interventional procedures; It is very effective in the treatment and survival of both CRC and HCC patients. In CRC patients with hepatic metastasis; The presence of extrahepatic metastasis, LTP development during the whole follow-up of the patient, the presence of mutant K-Ras oncogene and the primary colon segment originating from metastasis significantly affect the overall and liver-progression-free survival values in the liver. In patients with hepatocellular carcinoma; the development of LTP during the whole follow-up process, the degree of differentiation of the tumor, the patient's CHILD score and the patient's AFP value when the first ablation therapy is applied significantly affect the overall and progression-free survival values in the liver. In both CRC and HCC groups with hepatic metastasis, these variables also affect local progression-free survival on a lesion basis. In addition, there was no statistically significant effect on the survival measurements of the thermal ablation technique MWA or RFA applied in two main patient groups.