Laparoscopic radiofrequency ablation for the management of colorectal liver metastases: 10-year experience
Laparoscopic radiofrequency ablation for the management of colorectal liver metastases: 10-year experience
复制标题
DOI：
10.1002/jso.23268
复制
发表时间：
2013-03-01
影响因子：
2.5
通讯作者：
Hansen, Paul D.
中科院分区：
文献类型：
--
作者：
Kennedy, Timothy J.;Cassera, Maria A.;Hansen, Paul D.
背景已发表的关于射频消融（RFA）治疗结直肠肝转移（CRLM）的结果差异很大，局部复发率为240%，5年生存率为1455%。本研究的目的是分析我们10年的腹腔镜RFA经验。方法2000年1月至2010年7月，对130例CRLM患者行腹腔镜RFA治疗。KaplanMeier分析用于评估生存率。进行单因素和多因素分析，以确定与生存和复发相关的因素。结果本组中位生存期为40.4个月，5年生存率为28.8%。总体而言，9.2%的患者局部复发（3.6%的肿瘤小于或等于3cm）。单变量分析显示，与生存率降低相关的因素为BMI（P=0.045）、直肠原发性（P=0.005）和肿瘤大小增加（P=0.002）。在多变量分析中，肿瘤大小增加（HR 1.29 [95% CI：1.041.59]; P=0.020）和双叶病变（HR 2.06 [95% CI：1.024.15]; P=0.044）与生存率降低相关。在单因素分析中，只有BMI与疾病复发相关（P=0.025）。结论我们的数据表明腹腔镜RFA可以达到40.4个月的中位生存期，局部复发率低。肿瘤小于或等于3cm的患者局部复发的风险降低。《肿瘤外科杂志》2013;107：324328. (c)2012 Wiley Periodicals，Inc.
Background Published results addressing the treatment of colorectal liver metastases (CRLM) with radiofrequency ablation (RFA) vary widely with local recurrence rates of 240% and 5-year survival of 1455%. The goal of this study was to analyze our 10-year experience with laparoscopic RFA. Methods From January 2000 to July 2010, 130 patients underwent laparoscopic RFA for CRLM. KaplanMeier analysis was used to assess survival. Univariate and multivariate analysis were performed to identify factors associated with survival and recurrence. Results In this cohort, median survival was 40.4 months with 5-year survival of 28.8%. Overall, 9.2% of patients had a local recurrence (3.6% for tumors 3cm or less). On univariate analysis, factors associated with decreased survival were BMI (P=0.045), rectal primary (P=0.005), and increased tumor size (P=0.002). On multivariate analysis, increased tumor size (HR 1.29 [95% CI: 1.041.59]; P=0.020) and bilobar disease (HR 2.06 [95% CI: 1.024.15]; P=0.044) were associated with decreased survival. On univariate analysis, only BMI was found to be associated with disease recurrence (P=0.025). Conclusions Our data demonstrate that laparoscopic RFA can achieve a median survival of 40.4 months with a low local recurrence rate. Patients with tumors 3cm or less have a decreased risk of local recurrence. J. Surg. Oncol. 2013;107:324328. (c) 2012 Wiley Periodicals, Inc.