Clinicopathological characteristics of the patients undergoing simultaneous treatment of the primary colorectal carcinoma and liver metastases.

<p>Clinicopathological characteristics of the patients undergoing simultaneous treatment of the primary colorectal carcinoma and liver metastases.</p

Disease-free survival in matched patients: RFA ± resection vs. only resection.

<p>Comparison of patients with synchronous CRLM undergoing surgical treatment including RFA (RFA ± resection) or only liver resection. P-value = 0.683 (stratified log-rank test).</p

Regression analysis of the comprehensive complication index (CCI) of patients with complications.

<p>Regression analysis of the comprehensive complication index (CCI) of patients with complications.</p

Clinicopathological characteristics of matched patients undergoing RFA as a part of treatment vs. liver resection only.

<p>Clinicopathological characteristics of matched patients undergoing RFA as a part of treatment vs. liver resection only.</p

Regression analysis of complication rate.

<p>Regression analysis of complication rate.</p

Clinicopathological characteristics of matched patients with synchronous liver metastases undergoing simultaneous or colorectal-first treatment.

<p>Clinicopathological characteristics of matched patients with synchronous liver metastases undergoing simultaneous or colorectal-first treatment.</p

Overall survival in matched patients: Simultaneous treatment vs. colorectal-first.

<p>Comparison of patients with synchronous CRLM undergoing the simultaneous treatment or the colorectal-first approach. P-value = 0.223 (stratified log-rank test).</p

Radiofrequency ablation is beneficial in simultaneous treatment of synchronous liver metastases and primary colorectal cancer

<div><p>Background</p><p>In patients with resectable synchronous colorectal liver metastases (CRLM), either two-staged or simultaneous resections of the primary tumor and liver metastases are performed. Data on radiofrequency ablation (RFA) for the treatment of CRLM during a simultaneous procedure is lacking. The primary aim was to analyze short-term and long-term outcome of RFA in simultaneous treatment. A secondary aim was to compare simultaneous resection with the colorectal-first approach.</p><p>Methods</p><p>Retrospective analysis of 241 patients with colorectal cancer and synchronous CRLM between 2000–2016. Median follow-up was 36.1 months (IQR 18.2–58.8 months). A multivariable analysis was performed to analyze the postoperative morbidity, using the comprehensive complication index. A propensity matched analysis was performed to compare survival rates.</p><p>Results</p><p>In multivariable analysis, the best predictor of lower complication severity was treatment with RFA (p = 0.040). Higher complication rates were encountered in patients who underwent an abdominoperineal resection (p = 0.027) or age > 60 years (p = 0.022). The matched analysis showed comparable overall survival in RFA treated patients versus patients undergoing a liver resection with a five year overall survival of 39.4% and 37.5%, respectively (p = 0.782). In a second matched analysis, 5-year overall survival rates in simultaneously treated patients (43.8%) was comparable to patients undergoing the colorectal first approach (43.0%, p = 0.223).</p><p>Conclusions</p><p>RFA treatment of CRLM in simultaneous procedures is associated with a lower complication severity and non-inferior oncological outcome as compared to partial liver resection. RFA should be considered a useful alternative to liver resection.</p></div

Example of representative cases analysed in this study showing Western blot of COX-2 in matched pairs of 11 noncirrhotic (upper panel) and 8 cirrhotic (lower panel) samples of HCC and tumor-adjacent liver parenchyma.

<p>(Adj: tumor-adjacent liver parenchyma; T: tumor (HCC)).</p

Clinicopathological characteristics of the cirrhotic and noncirrhotic patient group.

1<p>α1-antitrypsin deficiency (n = 2); glycogenosis type III (n = 1); tyrosinemia (n = 2).</p