Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer

Abstract

This study evaluated the efficacy of percutaneous radiofrequency ablation (RFA) for the treatment of metachronous liver metastases of gastric cancer. We enrolled a total of 44 patients who underwent percutaneous RFA for the treatment of metachronous liver metastases after resection of a primary gastric adenocarcinoma from January 2002 to November 2011. The primary endpoint of this study was overall survival (OS) and recurrence-free survival (RFS) after RFA. Systemic chemotherapy was combined with RFA in 40 patients; the OS and RFS of the patients with liver-only metastasis who underwent RFA and chemotherapy were 20.9 months (95% CI 18.4-23.4) and 9.8 months (95% CI 9.2-10.5), respectively. On multivariate analysis, the factors independently, negatively associated with OS were extrahepatic metastatic lesions (HR 12.6, 95% CI 3.7-42.9; p=0.001), no chemotherapy (HR 43.3, 95% CI 7.4-251.3; p=0.001), and tumor number≥2 (HR 2.6, 95% CI 1.2-5.9; p=0.015). The factors independently, negatively associated with RFS were extrahepatic metastatic lesions (HR 3.6, 95% CI 1.6-7.8; p=0.003) and bilobar intrahepatic distribution (HR 3.9, 95% CI 1.5-9.9; p=0.001). The efficacy of percutaneous RFA for metachronous liver metastases of gastric cancer is limited to patients with a single, unilobar metastasis without extrahepatic metastatic lesions. Combined systemic chemotherapy is very important for the prolongation of OS.

Fig. 1

Overall survival curve for patients with liver-only metastases who underwent radiofrequency ablation and chemotherapy (blue line) and patients with extrahepatic metastatic lesion who underwent the same treatment (green line). (Color figure online)

Fig. 2

Recurrence-free survival curve for patients with liver-only metastases who underwent radiofrequency ablation and chemotherapy (blue line) and patients with extrahepatic metastatic lesion who underwent the same treatment (green line). (Color figure online)