Patterns of Recurrence After Ablation of Colorectal Cancer Liver Metastases
Patterns of Recurrence After Ablation of Colorectal Cancer Liver Metastases
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DOI：
10.1245/s10434-011-2048-x
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发表时间：
2012-03-01
影响因子：
3.7
通讯作者：
Jarnagin, William R.
中科院分区：
文献类型：
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作者：
Kingham, T. Peter;Tanoue, Michael;Jarnagin, William R.
目的 确定结直肠癌肝转移瘤术中消融后的局部复发率和与复发相关的因素。对 1996 年 4 月至 2010 年 3 月在手术室接受肝结直肠癌转移消融术的患者进行前瞻性维护的数据库进行回顾性分析。使用 Kaplan-Meier 生存曲线和 Cox 模型确定复发率并评估显着性。消融在 10%（n = 158）中进行研究期间所有病例的患者）。百分之七十八是与肝脏切除术一起进行的。在 315 个被消融的肿瘤中，大多数肿瘤的最大直径只有 1 厘米（53%）。射频消融用于治疗大多数肿瘤（70%）。 36 个肿瘤 (11%) 出现局部复发，这是其复发模式的一部分。 212 个肿瘤（67%）被消融后，疾病在肝脏或全身复发。单变量分析显示，肿瘤大小大于 1 cm 与局部复发风险显着增加相关（风险比 2.3，95% 置信区间 1.2-4.5，P = 0.013）。对于千分之1厘米的肿瘤，2年消融区无复发生存率为92%，而> 1厘米的肿瘤为81%。多变量分析显示，肿瘤大小 > 1 cm、术后缺乏化疗以及使用冷冻疗法与较高的局部复发率显着相关。对于千分之1 cm 的肝结直肠肿瘤，术中消融似乎是高效的治疗方法。
To determine the local recurrence rate and factors associated with recurrence after intraoperative ablation of colorectal cancer liver metastases.A retrospective analysis of a prospectively maintained database was performed for patients who underwent ablation of a hepatic colorectal cancer metastasis in the operating room from April 1996 to March 2010. Kaplan-Meier survival curves and Cox models were used to determine recurrence rates and assess significance.Ablation was performed in 10% (n = 158 patients) of all cases during the study period. Seventy-eight percent were performed in conjunction with a liver resection. Of the 315 tumors ablated, most tumors were a parts per thousand currency sign1 cm in maximum diameter (53%). Radiofrequency ablation was used to treat most of the tumors (70%). Thirty-six tumors (11%) had local recurrence as part of their recurrence pattern. Disease recurred in the liver or systemically after 212 tumors (67%) were ablated. On univariate analysis, tumor size greater than 1 cm was associated with a significantly increased risk of local recurrence (hazard ratio 2.3, 95% confidence interval 1.2-4.5, P = 0.013). The 2 year ablation zone recurrence-free survival was 92% for tumors a parts per thousand currency sign1 cm compared to 81% for tumors > 1 cm. On multivariate analysis, tumor size of > 1 cm, lack of postoperative chemotherapy, and use of cryotherapy were significantly associated with a higher local recurrence rate.Intraoperative ablation appears to be highly effective treatment for hepatic colorectal tumors a parts per thousand currency sign1 cm.