Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: Midterm results in 27 patients
Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: Midterm results in 27 patients
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DOI：
10.1016/j.jvir.2007.06.027
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发表时间：
2007-10-01
影响因子：
2.9
通讯作者：
Kanazawa, Susumu
中科院分区：
文献类型：
--
作者：
Hiraki, Takao;Gobara, Hideo;Kanazawa, Susumu
目的：回顾性评价射频消融治疗结直肠癌肺转移灶的中期预后（如安全性、局部疗效和生存率）。材料和方法：27例结直肠癌患者（19男8女，平均年龄61.6岁）49例肺转移灶（平均长轴直径1.5 cm）接受了41次经皮计算机断层扫描（CT）引导的射频消融治疗。所有患者均行CT随访，给予对比剂；5例患者行正电子发射断层扫描。评估手术的安全性、局部肿瘤控制和患者生存。分析多个变量以确定预后因素。结果：41次手术中有20次（49%）发生气胸，其中3次需要置胸管。41次手术中有6次（15%）出现少量胸腔积液。未见大出血事件。没有病人因手术而死亡。中位随访时间为20.1个月（范围11.2-47.7个月）。1年、2年和3年的一级和二级技术有效率分别为72%和85%、56%和62%。射频消融后1年的总生存率为96%，2年为54%，3年为48%。肺外转移的存在被确定为预后因素（P = 0.001）。结论：经皮射频消融治疗结直肠肺转移瘤的中期结果似乎很有希望。肺外转移的存在对射频消融后的生存有不利影响。
PURPOSE: To retrospectively evaluate the midterm outcomes (eg, safety, local efficacy, and survival) after radiofrequency (RF) ablation for pulmonary metastases from colorectal cancer.MATERIALS AND METHODS: Twenty-seven patients (19 men and eight women; mean age, 61.6 years) with 49 pulmonary metastases (mean long axis diameter, 1.5 cm) from colorectal cancer underwent 41 percutaneous computed tomography (CT)-guided RF ablation sessions. Follow-up examinations were performed with CT by using contrast medium administration in all patients; positron emission tomography was performed in five patients. The safety of the procedure, local tumor control, and patient survival were evaluated. Multiple variables were analyzed to determine prognostic factors.RESULTS: Pneumothorax occurred after 20 of the 41 sessions (49%), three of which necessitated chest tube placement. A small pleural effusion was found after six of the 41 sessions (15%). No maj or hemorrhagic event was observed. None of the patients died due to the procedure. The median follow-up period was 20.1 months (range, 11.2-47.7 months). The primary and secondary technique effectiveness rates were 72% and 85%, respectively, at 1 year, 56% and 62% at 2 years, and 56% and 62% at 3 years. The overall survival rates after RF ablation were 96% at 1 year, 54% at 2 years, and 48% at 3 years. The presence of extrapulmortary metastasis was determined to be a prognostic factor (P =.001).CONCLUSIONS: The midterm outcomes of percutaneous RF ablation for colorectal pulmonary metastases appear promising. The presence of extrapulmonary metastasis had an adverse effect on survival after RF ablation.