Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer.
Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer.
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DOI：
10.1007/s10585-013-9606-5
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发表时间：
2014-01
影响因子：
4
通讯作者：
Chung IJ
中科院分区：
文献类型：
--
作者：
Hwang JE;Kim SH;Jin J;Hong JY;Kim MJ;Jung SH;Shim HJ;Bae WK;Hwang EC;Kim JW;Shin SS;Jeong O;Park YK;Cho SH;Chung IJ
本研究评价经皮射频消融（RFA）治疗胃癌异时性肝转移的疗效。我们从2002年1月至2011年11月共纳入44例经皮RFA治疗原发性胃腺癌切除术后异时性肝转移的患者。该研究的主要终点是RFA后的总生存期（OS）和无复发生存期（RFS）。40例患者全身化疗联合RFA；单纯肝转移患者行RFA +化疗的OS和RFS分别为20.9个月（95% CI 18.4 ~ 23.4）和9.8个月（95% CI 9.2 ~ 10.5）。在多因素分析中，与OS负相关的独立因素是肝外转移病变（HR 12.6, 95% CI 3.7-42.9, p = 0.001）、未化疗（HR 43.3, 95% CI 7.4-251.3, p = 0.001）和肿瘤数≥2 （HR 2.6, 95% CI 1.2-5.9, p = 0.015）。与RFS负相关的独立因素是肝外转移病变（HR 3.6, 95% CI 1.6-7.8; p = 0.003）和双叶肝内分布（HR 3.9, 95% CI 1.5-9.9; p = 0.001）。经皮射频消融术治疗胃癌异时性肝转移的疗效局限于没有肝外转移病变的单一单叶转移患者。联合全身化疗对延长OS非常重要。
This study evaluated the efficacy of percutaneous radiofrequency ablation (RFA) for the treatment of metachronous liver metastases of gastric cancer. We enrolled a total of 44 patients who underwent percutaneous RFA for the treatment of metachronous liver metastases after resection of a primary gastric adenocarcinoma from January 2002 to November 2011. The primary endpoint of this study was overall survival (OS) and recurrence-free survival (RFS) after RFA. Systemic chemotherapy was combined with RFA in 40 patients; the OS and RFS of the patients with liver-only metastasis who underwent RFA and chemotherapy were 20.9 months (95 % CI 18.4–23.4) and 9.8 months (95 % CI 9.2–10.5), respectively. On multivariate analysis, the factors independently, negatively associated with OS were extrahepatic metastatic lesions (HR 12.6, 95 % CI 3.7–42.9; p = 0.001), no chemotherapy (HR 43.3, 95 % CI 7.4–251.3; p = 0.001), and tumor number ≥2 (HR 2.6, 95 % CI 1.2–5.9; p = 0.015). The factors independently, negatively associated with RFS were extrahepatic metastatic lesions (HR 3.6, 95 % CI 1.6–7.8; p = 0.003) and bilobar intrahepatic distribution (HR 3.9, 95 % CI 1.5–9.9; p = 0.001). The efficacy of percutaneous RFA for metachronous liver metastases of gastric cancer is limited to patients with a single, unilobar metastasis without extrahepatic metastatic lesions. Combined systemic chemotherapy is very important for the prolongation of OS.