Related Experiment Video
Updated: Jan 9, 2026
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Repeat ablation and single-session ablation in patients with multiple colorectal cancer liver metastases after
Si-Qi Gao1, Bo-Wen Zhang2, Qi-Yu Zhao1
1Department of Ultrasound, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Background:
The feasibility and safety of radiofrequency ablation (RFA) for oligometastatic colorectal liver metastases (CRLM) have been well established. However, the role of RFA in multiple metastases after first-line chemotherapy failure remains underexplored.
Aim:
To assess long-term survival and factors affecting outcomes of RFA in patients with multiple refractory CRLM.
Methods:
A retrospective study was conducted on patients who underwent ablation of CRLM at our institution between January 2015 and June 2024. A total of 80 patients were included, with 42 individuals receiving single-session ablation and 38 underwent repeat ablation. Enhanced computed tomography imaging was utilized to evaluate procedural efficacy 24 hours post-RFA, followed by follow-up scans every 3-4 months. Progression-free survival (PFS) and overall survival (OS) rates were compared at endpoint using Kaplan-Meier curves. Cox regression was used to identify the factors associated with OS and PFS.
Results:
The technical success rate was recorded at 98.7%. At endpoint, 42 (52.5%) patients achieved tumor-free survival, while 28 (35%) remained alive with residual tumors present. No significant OS/PFS differences existed between single-session (median follow-up 29.5 months, median PFS 24.5 months) and repeat ablation (30 months, 14 months) cohorts (P > 0.05). Multivariate analysis showed that larger tumor size (P < 0.001) and older age (P = 0.01) were associated with worse OS. The median PFS was 13.5 months, with tumor size emerging as the only independent predictor (P = 0.04).
Conclusion:
For patients with multiple refractory CRLM, both single-session ablation and repeat ablation can increase the proportion of patients achieving tumor-free status. However, careful consideration is necessary for ablation of metastases larger than 2.7 cm.
