Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies - Results in 123 patients
Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies - Results in 123 patients
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DOI：
10.1097/00000658-199907000-00001
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发表时间：
1999-07-01
影响因子：
9
通讯作者：
Cremona, F
中科院分区：
文献类型：
--
作者：
Curley, SA;Izzo, F;Cremona, F
目的探讨射频消融（RFA）治疗不能手术切除的肝脏恶性肿瘤的安全性和有效性。局部应用热是杀肿瘤的，因此，作者研究了一种新的RFA系统来治疗患者与不可切除的hepatic cancer.Patients和MethodsPatients与肝脏恶性肿瘤进入一个前瞻性的，非随机试验。在超声引导下，使用新型LeVeen单极阵列针电极和RF 2000发生器，对肝脏肿瘤进行围手术期或术中治疗。所有患者进行了随访，以评估并发症，治疗反应，和复发的恶性diseases.ResultsRFA被用来治疗169肿瘤（中位直径3.4厘米，范围0.5至12厘米）在123例。48例患者（39.1%）接受了原发性肝癌治疗，75例患者（60.9%）接受了转移性肝肿瘤治疗。31例患者（35.2%）和92例患者（74.8%）分别接受了经皮和术中RFA。无治疗相关死亡，RFA后并发症发生率为2.4%。在完成RFA治疗后，所有治疗的肿瘤在成像研究中完全坏死。中位随访时间为15个月，169个治疗病灶中有3个（1.8%）肿瘤复发，但34例患者（27.6%）在其他部位发生了转移性疾病。由于患者在RFA后有发生新的转移性疾病的风险，因此应研究包括RFA在内的多模式治疗方法。
ObjectiveTo describe the safety and efficacy of radiofrequency ablation (RFA) to treat unresectable malignant hepatic tumors in 123 patients.BackgroundThe majority of patients with primary or metastatic malignancies confined to the liver are not candidates for resection because of tumor size, location, or multifocality or inadequate functional hepatic reserve. Local application of heat is tumoricidal; therefore, the authors investigated a novel RFA system to treat patients with unresectable hepatic cancer.Patients and MethodsPatients with hepatic malignancies were entered into a prospective, nonrandomized trial. The liver tumors were treated percutaneously or during surgery under ultrasound guidance using a novel LeVeen monopolar array needle electrode and an RF 2000 generator. All patients were followed to assess complications, treatment response, and recurrence of malignant disease.ResultsRFA was used to treat 169 tumors (median diameter 3.4 cm, range 0.5 to 12 cm) in 123 patients. Primary liver cancer was treated in 48 patients (39.1%), and metastatic liver tumors were treated in 75 patients (60.9%). Percutaneous and intraoperative RFA was performed in 31 patients (35.2%) and 92 patients (74.8%), respectively. There were no treatment-related deaths, and the complication rate after RFA was 2.4%. All treated tumors were completely necrotic on imaging studies after completion of RFA treatments. With a median follow-up of 15 months, tumor has recurred in 3 of 169 treated lesions (1.8%), but metastatic disease has developed at other sites in 34 patients (27.6%).ConclusionsRFA is a safe, well-tolerated, and effective treatment to achieve tumor destruction in patients with unresectable hepatic malignancies. Because patients are at risk for the development of new metastatic disease after RFA, multimodality treatment approaches that include RFA should be investigated.