Efficacy and safety of thermal ablation in patients with liver metastases
Efficacy and safety of thermal ablation in patients with liver metastases
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DOI：
10.1097/meg.0b013e32835cb566
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发表时间：
2013-04-01
影响因子：
2.1
通讯作者：
Zheng, Yun
中科院分区：
文献类型：
--
作者：
Liu, Yingjun;Li, Shengping;Zheng, Yun
目的热消融治疗原发性肝癌安全有效。然而，其在肝转移方面仍然存在问题。在这里，我们的目的是评估的有效性和安全性的热消融治疗肝转移瘤患者。方法89例患者的132个肝转移瘤直径为0.8-5.0 cm的微波消融（MWA）或射频消融（RFA）治疗。原发灶分别为大肠癌38例和其他51例。局部肿瘤控制，并发症，和长期survival.Results完全消融117 132（88.6%）结节实现。117例成功治疗的结节中有17例（14.5%）局部复发。在单变量分析中，观察到MWA的局部复发率显著降低（MWA为8.6%，RFA为20.3%，P = 0.072）。多因素分析显示，化疗周期数是总复发的重要预后因素（P = 0.015），而无病期是远处复发的重要预后因素（P = 0.030）。消融方式对局部复发具有潜在的预后意义（P = 0.053）。1.1%的患者发生严重并发症。未观察到手术相关死亡。首次消融后1、2、3、5年生存率分别为84.9%、59.6%、48.8%、36.3%。MWA的局部复发率可能低于RFA。Eur J Gastroenterol Hepatol 25：442-446（C）2013 Wolters Kluwer Health|利平科特威廉姆斯&威尔金斯。欧洲胃肠病学和肝病学杂志2013，25：442-446
Objective Thermal ablation is safe and effective for the treatment of hepatocellular carcinoma. However, it remains problematic with respect to liver metastases. Here, we aimed to evaluate the efficacy and safety of thermal ablation in patients with liver metastases.Methods Eighty-nine patients with 132 liver metastases measuring 0.8-5.0 cm were treated with microwave ablation (MWA) or radiofrequency ablation (RFA). The primary lesions were colorectal cancer in 38 cases and others in 51, respectively. Local tumor control, complications, and long-term survival were analyzed.Results Complete ablation was achieved in 117 of 132 (88.6%) nodules. Seventeen of the 117 (14.5%) successfully treated nodules developed local recurrence. In a univariate analysis, a significant trend toward a lower local recurrence rate with MWA was observed (8.6% for MWA vs. 20.3% for RFA, P = 0.072). Multivariate analysis showed that number of cycles of chemotherapy was the significant prognostic factor for overall recurrence (P = 0.015), whereas disease-free interval was the significant prognostic factor for distant recurrence (P = 0.030). Ablation modality showed potential prognostic significance for local recurrence (P = 0.053). Major complications occurred in 1.1% of patients. No procedure-related mortalities were observed. The 1, 2, 3, and 5-year overall survival rates after the initial ablation were 84.9, 59.6, 48.8, and 36.3%, respectively.Conclusion Thermal ablation is a safe and effective treatment for patients with liver metastases. MWA has the potential to result in less local recurrence than RFA. Eur J Gastroenterol Hepatol 25:442-446 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:442-446