Evaluating the effectiveness and safety of chemotherapy before surgery plus radiofrequency ablation for patients with colorectal cancer liver metastases.

This study evaluated the effectiveness and safety of chemotherapy given before surgery (neoadjuvant chemotherapy; NAC) followed by radiofrequency ablation (RFA) for the treatment of patients with colorectal cancer liver metastasis. The data showed that NAC plus RFA improved survival outcomes in these patients.

Colorectal cancer (CRC) is one of the most common types of cancer worldwide. The first choice for the treatment of CRC is usually surgery. In 50% of the cases, cancer spreads to the liver known as colorectal cancer liver metastasis. Less than 20% of these patients are eligible for surgery to remove the metastases. Often, these patients are given chemotherapy before surgery (neoadjuvant chemotherapy; NAC) to shrink the cancer so that it can be completely removed by surgery.

In patients where surgery is not possible, radiofrequency ablation (RFA) is usually recommended to remove the metastases. RFA is a medical procedure where pieces of tissue are removed using the heat that is produced from an electrical current. It is a minimally invasive procedure. It involves electrodes being inserted under the skin and into the tumor. A current is then passed through the electrodes which generate heat and kill the tumor cells. However, the effectiveness and safety of NAC followed by RFA for the treatment of patients with colorectal cancer liver metastasis are still not known.

This study involved 149 patients with colorectal cancer liver metastasis. Patients were divided into 2 groups. Group 1 included 61 patients who received RFA plus NAC. Group 2 included 88 patients who received RFA only. The average follow-up time was 30 months.

The 3-year overall survival rate was higher in group 1 (73.6%) versus group 2 (46.2%). The 3-year survival rate without cancer worsening was higher in group 1 (46%) versus group 2 (17.7%). The 3-year survival rate without local tumor progression was also higher in group 1 (84.9%) versus group 2 (60.9%).

16.4% of the patients in group 1 experienced complications after RFA compared to 3.4% of the patients in group 2.

This study concluded that NAC plus RFA improved survival outcomes in patients with colorectal cancer liver metastasis.

This study looked back in time at medical records. It only included patients from a single institution in China. The sample size was very small. It did not include patients with RAS genetic abnormalities (mutations).