Comparative analysis of the efficacy of radiofrequency ablation versus liver resection in the treatment of gastrointestinal stromal tumor liver metastases
10.3760/cma.j.cn115396-20240306-00062
- VernacularTitle:射频消融术与肝切除术在胃肠间质瘤肝转移中的疗效对比分析
- Author:
Linde SUN
1
;
Zhida CHEN
;
Xiaoyu DONG
;
Wentong XU
Author Information
1. 中国人民解放军总医院第一医学中心普通外科医学部，北京 100853
- Keywords:
Gastrointestinal neoplasms;
Hepatectomy;
Neoplasm metastasis;
Gastrointestinal stromal tumor;
Radiofrequency ablation;
Liver metastasis
- From:
International Journal of Surgery
2024;51(4):241-245
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of radiofrequency ablation and liver resection in the treatment of gastrointestinal stromal tumor liver metastasis.Methods:A retrospective cohort study was conducted, collecting medical records of 46 patients with gastrointestinal stromal tumor liver metastasis treated at the First Medical Center of the Chinese People′s Liberation Army General Hospital from January 2018 to December 2022. Patients were divided into radiofrequency ablation group ( n=20) and liver resection group ( n=26) based on the treatment method. Short-term efficacy and long-term prognosis between the two groups were compared. Short-term efficacy was evaluated based on intraoperative bleeding volume, operative time, hospital stay, hospitalization costs, while long-term efficacy was assessed by progression-free survival and overall survival. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Non-normally distributed measurement data were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Count data were expressed as frequency (%) and compared using the chi-square test. The long-term prognosis of patients in both groups was compared using the Kaplan-Meier curve. Results:The intraoperative blood loss, operative time, postoperative hospital stay, and hospitalization costs for the radiofrequency ablation group were 5 (3, 5) mL, 60 (55, 60) min, 4.0 (3.0, 4.0) d, and 4.6 (3.8, 5.3) ten thousand yuan, respectively; for the liver resection group, these were 100 (50, 275) mL, 180 (155, 215) min, 7.0 (4.5, 9.5) d, and 8.6 (6.1, 10.8) ten thousand yuan, respectively, with statistically significant differences between the two groups( P<0.05). The median progression-free survival for the liver resection group was 37 months, with 1 and 3-year progression-free survival rates of 96% and 50%, respectively. For the radiofrequency ablation group, the median progression-free survival was 20.5 months, with 1 and 3-year progression-free survival rates of 65% and 20%, respectively, showing statistically significant differences between the two groups ( P<0.05). The 1, 3, and 5-year overall survival rates for the liver resection group were 100%, 100%, and 78.3%, respectively, while for the radiofrequency ablation group, they were 100%, 100%, and 82.2%, respectively, with no statistically significant difference ( P>0.05). Conclusions:Both liver resection and radiofrequency ablation can be considered as treatment options for gastrointestinal stromal tumor liver metastasis, with comparable long-term efficacy. Liver resection has a clear advantage in terms of local tumor control compared to radiofrequency ablation, which has the advantages of fewer complications, faster recovery, and shorter hospital stay.
