The local efficacy of microwave ablation versus surgical resection for subcapsular colorectal liver metastases
Mené à partir de données portant sur 519 patients présentant des métastases hépatiques sous-capsulaires ayant pour origine un cancer colorectal, cette étude évalue l'efficacité, du point de vue du taux de contrôle local, d'une ablation par micro-ondes par rapport à une résection chirurgicale
Introduction: The effectiveness of microwave ablation (MWA) versus surgical resection (SR) for subcapsular colorectal liver metastases (CRLM) is debated, with limited clinical evidence. This study examines the local therapeutic efficacy and complications of MWA and SR for treating subcapsular CRLM.
Materials and Methods: Between January 2013 and December 2020, 519 patients with subcapsular CRLMs were retrospectively included. This research was conducted on 768 subcapsular CRLM (621 in the MWA group and 147 in the SR group). Propensity score matching (PSM) with a ratio of 1:2 and adjusted Cox proportional hazards regression were utilized to balance the potential bias between the two groups. Local tumor progression (LTP) rate and complication rate were compared between the two groups.
Results: After PSM, 363 CRLMs were matched: 232 in the MWA group and 131 in the SR group. Before PSM, LTP was 13.5% and 16.3% for MWA and SR groups; after PSM, it was 18.9% and 15.2% for MWA and SR groups. No significant difference in LTPFS between the groups (multivariable analysis, p = 0.395; PSM analysis, p = 0.374). Multivariable analysis identified protrusion as a significant factor for poor LTPFS in the MWA group. In the protruding CRLMs subgroup, SR resulted in superior LTPFS compared to MWA (p = 0.037). The MWA group had a significantly lower minor and major complication rate than the SR group (both p < 0.001).
Conclusion: Compared with SR, MWA provides comparable local tumor control and lower complication rates for subcapsular CRLM. SR is preferable for protruding CRLM.
European Journal of Surgical Oncology , résumé, 2026