Local recurrences after intraoperative radiofrequency ablation of liver metastases: A comparative study with anatomic and wedge resections
Local recurrences after intraoperative radiofrequency ablation of liver metastases: A comparative study with anatomic and wedge resections
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DOI：
10.1245/aso.2004.08.019
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发表时间：
2004-05-01
影响因子：
3.7
通讯作者：
Lasser, P
中科院分区：
文献类型：
--
作者：
Elias, D;Baton, O;Lasser, P
背景资料：肝转移瘤（LM）术中射频消融（RFA）的适应症和结果在文献中没有很好的定义，也从未与肝切除术进行过比较。本研究的目的是了解局部复发率的RFA比较解剖和楔形切除术。方法：88例技术上无法切除的LM治疗的治疗意图。当LM较大时，通过解剖切除术（40例患者，213个LM）治疗，当外周和较小时，通过楔形切除术（64例患者，99个LM）治疗，当中央和较小时，通过RFA（88例患者，227个LM）治疗。中位随访时间为27.6个月（范围：15-74个月），共治疗了539例LM（平均每例患者5例）。结果：227例RFA的局部复发率为5.7%，99例楔形切除术的局部复发率为7.1%，40例解剖切除术的局部复发率为12.5%（P = 0.216）。RFA后的局部复发率与大于30 mm的LM（P < .001）和与大血管直接接触的LM（P < .001）相关。结论：就局部控制而言，RFA与楔形或解剖切除术一样有效和安全。
Background: The indications and results of intraoperative radiofrequency ablation (RFA) of liver metastases (LMs) are not well defined in the literature and have never been compared with those of hepatectomy. The aim of the study was to appreciate the local recurrence rate of RFA in comparison with anatomic and wedge resection.Methods: Eighty-eight patients with technically unresectable LMs were treated with curative intent. The LMs were treated by anatomic resection (40 patients, 213 LMs) when large, by wedge resection (64 patients, 99 LMs) when peripheral and small, and by RFA (88 patients, 227 LMs) when central and small. The median follow-up was 27.6 months (range, 15-74 months), and a total of 539 LMs were treated (median of 5 per patient).Results: The local recurrence rates were 5.7% for the 227 RFAs, 7.1% for the 99 wedge resections, and 12.5% for the 40 anatomic resections (P = .216). Local recurrence rates after RFA were correlated with LMs larger than 30 mm (P < .001) and with LMs in direct contact with large vessels (P < .001).Conclusions: RFA is as efficient and safe as wedge or anatomic resections in terms of local control.