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Comparative analysis of treatment of patients with metastatic colorectal cancer using local destruction methods

https://doi.org/10.17238/2072-3180-2026-1-116-122

Abstract

Introduction. Approximately 90 % of liver tumors are metastatic, predominantly from colorectal cancer (CRC). Only 10–25 % of such metastases are resectable. The median survival is less than a year without treatment and even with chemotherapy it does not exceed 18 months. The aim of the study to improve the effectiveness of treatment for patients with colorectal cancer liver metastases using minimally invasive local destruction methods.

Materials and methods of research. The study included 257 patients with CRC liver metastases (2002–2024). All patients underwent ultrasound, contrast-enhanced MRI/CT, PET-CT, and 3D modeling (MYRIAN XP-Liver) for treatment planning. All patients received combined therapy: chemotherapy according to FOLFOX/XELOX/FOLFIRI regimens ± targeted therapy.

Transarterial chemoembolization (TACE): 34 patients (to shrink tumors >4 cm). Radiofrequency ablation (RFA): 121 patients (tumors 1–5 cm). Microwave ablation (MWA): 57 patients (tumors 1–3,5 cm). Laser ablation (LA): 45 patients (tumors 1–3,3 cm).

Treatment results. Survival in the RFA group: 1 year – 73,5 %, 2 years – 53,3 %, 3 years – 32,1 %. MWA: 1 year – 78,5 %, 2 years – 63,3 %, 3 years – 58,3 %. LA: 1 year – 88 %, 2 years – 71 %, 3 years – 43,5 %. Median relapse-free survival is 8,5 months. The 1-year survival rate in the subgroup of 12 patients was 84 %. Mortality was 0,6 % (2 cases in the RFA group). The average hospital stay was 7 days.

Conclusion. The use of minimally invasive thermodestruction methods (RFA, MWA, LA) within a multidisciplinary approach significantly expands treatment indications for non-resectable patients (with severe comorbidities, bilobar involvement, low functional liver reserve). This increases overall resectability to 35–40 %, reduces surgical risks and the number of complications, shortens hospitalization times, and improves survival rates.

About the Authors

M. M. Trandofilov
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Trandofilov Mikhail Mikhailovich – PhD in medicine, the professor of the Department of Operative Surgery and Topographic Anatomy, the surgeon of the Surgical Department of the University Clinic of the N.A. Semashko Scientific Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


E. N. Prazdnikov
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Prazdnikov Eric Narimanovich – PhD in medicine, professor, the head of the Department of Operative Surgery and Topographic Anatomy 

111398, Kuskovskaya 1A str., building 4, Moscow


S. G. Teryasov
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Teryasov Sergey Grigorievich – the assistant of the Department of Operative Surgery and Topographic Anatomy, the surgeon of the Surgical Department of the University Clinic of the N.A. Semashko Scientific Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


D. Yu. Sinyavin
JSC Multidisciplinary Clinic SOYUZ
Russian Federation

Sinyavin Dmitry Yuryevich – Oncologist

Moscow, 107076, Matrosskaya Tishina Street, Building 14A


V. P. Shevchenko
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Vadim Pavlovich Shevchenko - MD, Professor, Department of Operative Surgery and Topographic Anatomy; Surgeon, Department of Surgery, University Clinic, N.A. Semashko Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


V. N. Manchurov
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Manchurov Vladimir Nikolaevich – Head of the Department of X-ray Surgical Diagnostic and Treatment Methods at the University Clinic of the N.A. Semashko Scientific Research Institute of Clinical Medicine, Federal State Budgetary Educational Institution of Higher Education, Cand. of Sci. (Med.), Associate Professor of the Department of Cardiology

111398, Kuskovskaya 1A str., building 4, Moscow


A. N. Sizova
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Anna Nikolaevna Sizova – MD, PhD, Associate Professor, Department of Operative Surgery and Topographic Anatomy; Surgeon, Department of Surgery, University Clinic, N.A. Semashko Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


I. A. Koshelev
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Koshelev Igor Andreevich – the assistant of the Department of Operative Surgery and Topographic Anatomy, the head of the 2nd Surgical Department of the University Clinic of the N.A. Semashko Scientific Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


V. S. Vakhromkin
FSBEI HE "Russian University of Medicine (RUM)" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Vakhromkin Vladimir Sergeevich – the assistant of the Department of Operative Surgery and Topographic Anatomy, the surgeon of the 2nd Surgical Department of the University Clinic of the N.A. Semashko Scientific Institute of Clinical Medicine

111398, Kuskovskaya 1A str., building 4, Moscow


P. G. Shkilnyuk
State Budgetary Healthcare Institution of the Moscow Region "Pushkin Clinical Hospital named after prof. V.N. Rozanov"
Russian Federation

Shkilnyuk Petr Gennadievich – physician-therapist, State Budgetary Healthcare Institution 

141206, Pushkino, Moscow Region, Aviatsionnaya St., 35


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Review

For citations:

Trandofilov M.M., Prazdnikov E.N., Teryasov S.G., Sinyavin D.Yu., Shevchenko V.P., Manchurov V.N., Sizova A.N., Koshelev I.A., Vakhromkin V.S., Shkilnyuk P.G. Comparative analysis of treatment of patients with metastatic colorectal cancer using local destruction methods. Moscow Surgical Journal. 2026;(1):116–122. (In Russ.) https://doi.org/10.17238/2072-3180-2026-1-116-122

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ISSN 2072-3180 (Print)
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