Impact of Prior Hepatectomy History on Local Tumor Progression after Percutaneous Ablation of Colorectal Liver Metastases.
Impact of Prior Hepatectomy History on Local Tumor Progression after Percutaneous Ablation of Colorectal Liver Metastases.
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DOI：
10.1016/j.jvir.2017.10.026
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Vauthey JN
中科院分区：
文献类型：
--
作者：
Odisio BC;Yamashita S;Huang SY;Kopetz SE;Ahrar K;Mizuno T;Conrad C;Aloia TA;Chun YS;Gupta S;Vauthey JN
为了验证假设，考虑到目前结肠直肠癌肝转移（CLM）的切除资格标准，既往肝切除术将与经皮CLM消融后改善局部肿瘤控制和生存相关。这项单机构回顾性研究包括2005年1月至2014年12月82例连续97例CLM患者接受消融术（射频、微波或冷冻消融术）治疗。从消融时间开始计算局部肿瘤无进展生存期（LTPFS）、任何器官无复发生存期（RFS）和总生存期（OS），并使用Kaplan-Meier方法比较既往肝切除术患者（n=49）和未手术患者（n=33）。Cox回归模型用于确定LTPFS的预测因子。中位总随访期为28个月（范围4.5-132）。3年精算LTPFS（患者水平：73% vs 34%， P < 0.001）分别显著高于未进行肝切除术的患者。同样，既往肝切除术患者的3年RFS （23% vs 9.1%, P = 0.026）和OS （78% vs 48%, P = 0.003）均得到改善。在多因素分析中，LTPFS恶化的预测因素为：没有肝切除术史（风险比[HR] 2.35, 95%可信区间[CI] 1.02-5.45; P = 0.045），最小消融边缘< 5mm（风险比2.4,95% CI 1.18-4.87; P = 0.016）， ras突变肿瘤（风险比2.65,95% CI 1.18-5.94; P = 0.019）。既往肝切除术治疗CLM与经皮消融术后发展的CLM改善局部肿瘤控制相关。
To test the hypothesis that, given the current resection eligibility criteria for colorectal liver metastasis (CLM), prior hepatectomy would be associated with improved local tumor control and survival after percutaneous ablation of CLM. This single-institution retrospective study included 82 consecutive patients with 97 CLM treated with ablation (radiofrequency, microwave, or cryoablation) from January 2005 to December 2014. Local tumor progression-free survival (LTPFS), recurrence-free survival at any organ (RFS), and overall survival (OS) were calculated from the time of ablation and compared between patients with (n=49) and without (n=33) prior hepatectomy using the Kaplan-Meier method. Cox regression models were used to identify LTPFS predictors. Median overall follow-up period was 28 months (range, 4.5–132). The 3-year actuarial LTPFS (patient level: 73% vs 34%, P < 0.001) were significantly higher in patients with than without prior hepatectomy, respectively. Similarly, three-year RFS (23% vs 9.1%, P = 0.026) and OS (78% vs 48%, P = 0.003) were improved in patients with prior hepatectomy. At multivariate analysis, predictors of worse LTPFS were: no prior hepatectomy (hazard ratio [HR] 2.35, 95% confidence interval [CI] 1.02–5.45; P = 0.045), minimal ablation margin < 5mm (HR 2.4, 95% CI 1.18–4.87; P = 0.016), and RAS-mutant tumor (HR 2.65, 95% CI 1.18–5.94; P = 0.019). Prior hepatectomy for CLM is associated with improved local tumor control after percutaneous ablation of post-resection developed CLM.
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DOI：
10.1002/bjs.10490
发表时间：
2017-05
期刊：
The British journal of surgery
影响因子：
--
作者：
Odisio BC;Yamashita S;Huang SY;Harmoush S;Kopetz SE;Ahrar K;Shin Chun Y;Conrad C;Aloia TA;Gupta S;Hicks ME;Vauthey JN
通讯作者：
Vauthey JN
DOI：
10.1016/j.jamcollsurg.2013.03.004
发表时间：
2013-07
影响因子：
5.2
作者：
Shindoh, Junichi;Vauthey, Jean-Nicolas;Zimmitti, Giuzeppe;Curley, Steven A.;Huang, Steven Y.;Mahvash, Armeen;Gupta, Sanjay;Wallace, Michael J.;Aloia, Thomas A.
通讯作者：
Aloia, Thomas A.
DOI：
10.6004/jnccn.2013.0022
发表时间：
2013-02-01
影响因子：
13.4
作者：
Benson, Al B., III;Bekaii-Saab, Tanios;Freedman-Cass, Deborah A.
通讯作者：
Freedman-Cass, Deborah A.
影响因子：
9
作者：
Fong, Y;Fortner, J;Blumgart, LH
通讯作者：
Blumgart, LH
影响因子：
45.3
作者：
Blazer, Dan G., III;Kishi, Yoji;Vauthey, Jean-Nicolas
通讯作者：
Vauthey, Jean-Nicolas