Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases
Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases
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DOI：
10.1007/s00330-011-2314-0
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发表时间：
2012-04-01
影响因子：
5.9
通讯作者：
Margreiter, Raimund
中科院分区：
文献类型：
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作者：
Bale, Reto;Widmann, Gerlig;Margreiter, Raimund
为了评价立体定向射频消融（SRFA）治疗结直肠肝转移（CRLM）患者的结局，在IRB批准后，对63例连续患者的189例CRLM进行了98次SRFA治疗。分析了局部复发率（LR）、总生存率（OS）和无病生存率（DFS），LR在16%的肿瘤（31/189）中被确定，当肿瘤大小<3cm（17.7%）、3- 5cm（11.1%）和> 5cm（17.4%）时，无显著差异（P = 0.635）。平均随访25个月（范围2-66）后，SRFA治疗的中位OS为33.2个月;相应的1年、3年和5年生存率分别为87%、44%和27%。当比较不可切除和可切除患者时，中位OS存在显著差异（27 vs. 58个月，P = 0. 002），可切除患者1年、3年和5年的OS率分别为92%、66%和48%。肿瘤大小不影响OS和DFS。由于良好的结局，SRFA挑战切除术作为CRLM患者的一线局部治疗。只要随机研究还在进行中，我们建议对每位患者进行个体化决策。立体定向射频消融（SRFA）可以有效治疗大肠癌肝转移瘤。使用SRFA的总生存率不受肿瘤大小的影响。与手术切除相比的无瘤生存率。a欧元区SRFA对手术切除作为结直肠癌肝转移的一线治疗提出了挑战。
To evaluate the outcome of patients with colorectal liver metastasis (CRLM) treated with stereotactic radiofrequency ablation (SRFA).Following IRB approval, a retrospective evaluation of 98 SRFA treatment sessions of 189 CRLMs in 63 consecutive patients was performed. Local recurrence rate (LR), overall survival (OS) and disease-free survival (DFS) were analysed.LR was identified in 16% of the tumours (31/189), with no significant differences (P = 0.635) when comparing tumour sizes < 3 cm (17.7%), 3-5 cm (11.1%) and > 5 cm (17.4%). The median OS from SRFA treatment was 33.2 months after a mean follow-up of 25 months (range 2-66); the corresponding 1-, 3- and 5- year survival rates were 87%, 44% and 27%. The median OS was significantly different when comparing unresectable and resectable patients (27 vs. 58 months, P = 0.002) with OS rates of 92%, 66% and 48% at 1, 3 and 5 years in resectable patients. Tumour size did not affect OS and DFS.Due to the favourable outcome, SRFA challenges resection as first-line local treatment of patients with CRLM. As long as randomised studies are pending, we recommend entering an individual decision-making process with every patient.aEuro cent Large colorectal liver metastases can be effectively treated by stereotactic radiofrequency ablation (SRFA).aEuro cent Using SRFA the overall survival is not affected by tumour size.aEuro cent SRFA achieves similar overall and disease-free survival rates as surgical resection.aEuro cent SRFA challenges surgical resection as the first-line treatment for colorectal liver metastases.