Complementary Use of Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastases: An Analysis of 395 Patients
Complementary Use of Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastases: An Analysis of 395 Patients
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DOI：
10.1007/s00268-013-1981-1
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发表时间：
2013-06-01
影响因子：
2.6
通讯作者：
Berber, Eren
中科院分区：
文献类型：
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作者：
Agcaoglu, Orhan;Aliyev, Shamil;Berber, Eren
肝切除术和射频消融（RFA）是治疗结直肠肝转移（CLM）患者的两种手术选择。本研究的目的是分析单中心CLM切除和RFA后的患者特征和结果。在2000年至2010年期间，395例CLM患者接受了RFA (n = 295)，肝切除术（n = 94）或两者兼有（n = 6），这些患者来自前瞻性irb批准的数据库。采用单因素和多因素分析对人口学、临床和生存数据进行分析。与切除术患者相比，RFA患者有更多的合并症、肝脏肿瘤数量和更高的肝外疾病发生率。RFA组的5年总实际生存率为17%，切除组为58% （p = 0.001）。在多因素分析中，多发性肝肿瘤、显性病变bbb30 3 cm和CEA >0 ng/ml是总生存期的独立预测因子。患者随访时间中位数为20 +/- 1个月。RFA组的肝脏和肝外复发分别为69%和29%，而切除组的肝脏和肝外复发分别为40%和19%。在这个大型外科系列中，我们描述了CLM患者接受切除或射频消融的特点和肿瘤预后。通过这两种选择，我们能够手术治疗大量出现不同程度肝脏肿瘤负担和合并症的患者，并在随访中控制肝脏复发。
Liver resection and radiofrequency ablation (RFA) are two surgical options in the treatment of patients with colorectal liver metastases (CLM). The aim of this study was to analyze patient characteristics and outcomes after resection and RFA for CLM from a single center.Between 2000 and 2010, 395 patients with CLM undergoing RFA (n = 295), liver resection (n = 94) or both (n = 6) were identified from a prospective IRB-approved database. Demographic, clinical and survival data were analyzed using univariate and multivariate analyses.RFA patients had more comorbidities, number of liver tumors and a higher incidence of extrahepatic disease compared to the Resection patients. The 5-year overall actual survival was 17 % in the RFA, 58 % in the Resection group (p = 0.001). On multivariate analysis, multiple liver tumors, dominant lesion > 3 cm, and CEA > 10 ng/ml were independent predictors of overall survival. Patients were followed for a median of 20 +/- A 1 months. Liver and extrahepatic recurrences were seen in 69 %, and 29 % of the patients in the RFA, and 40 %, and 19 % of the patients in the Resection group, respectively.In this large surgical series, we described the characteristics and oncologic outcomes of patients undergoing resection or RFA for CLM. By having both options available, we were able to surgically treat a large number of patients presenting with different degrees of liver tumor burden and co-morbidities, and also manage liver recurrences in follow-up.