Analysis of Prognostic Factors of Colorectal Cancer Liver Metastasis after Microwave Ablation
Objective: To investigate the risk factors associated with intrahepatic recurrence and survival after microwave ablation (MWA) for colorectal cancer with liver metastases. Methods: Retrospective analysis of clinical, pathological and follow-up data of 60 patients who underwent ultrasound-guided microwave ablation for treating liver metastases from January 2013 to December 2015 at the Sixth Affiliated Hospital, Sun Yat-Sen University, with Cox univariate and multifactorial regression analyses of risk factors affecting intrahepatic recurrence and overall survival after ablation of liver metastases. Results: After follow-up for 12.5 to 47.4 months, intrahepatic recurrence occurred in 26 cases, of which 6.1% (7/114) showed local tumor progression at the original ablation site; 11 cases died for tumor-related reasons. Multi-factor Cox regression analysis showed that age ≥60 years and maximum diameter of liver metastases ≥2 cm were independent risk factors for patients to develop intrahepatic recurrence after surgery. HBsAb positivity and chemotherapy after ablation until intrahepatic recurrence are independent protective factors for patients developing intrahepatic recurrence after surgery. Multi-factor Cox regression analysis showed that the number of liver metastases ≥3 was an independent risk factor for overall survival. Conclusion: After microwave ablation for patients with colorectal cancer liver metastases, patients aged ≥60 years, HBsAb negative and with maximum liver metastases ≥2 cm in diameter were more likely to have recurrent intrahepatic metastases, while aggressive chemotherapy after ablation was effective in reducing recurrent intrahepatic metastases, and the number of liver metastases ≥3 indicated a poor overall prognosis.
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