Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years' experience.
Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years' experience.
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DOI：
10.18632/oncotarget.18764
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发表时间：
2017-11-21
期刊：
影响因子：
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通讯作者：
Hu Y
中科院分区：
文献类型：
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作者：
Zhou F;Yu X;Liang P;Han Z;Cheng Z;Yu J;Liu F;Hu Y
热消融已被认为是不能切除的结直肠癌肝转移患者局部治疗意图的替代方案。原发灶位置对接受微波消融的结直肠癌肝转移患者预后的影响尚不清楚。我们回顾了2006年3月至2016年3月期间在我们机构接受微波消融治疗结直肠癌肝转移的295名患者。进行单变量和多变量分析，以确定总体和无进展生存率的预测因素。手术成功率为96.6%(n=289)，术后并发症发生率为2.0%(n=6)。在中位随访24个月(范围2-86个月)后，观察到不同原发肿瘤部位的患者的总体生存率相似(p=0.583)。左侧原发结直肠癌肝转移患者的无进展生存率高于右侧原发癌患者(风险比：0.67，95.0%可信区间：0.48~0.94；p=0.012)，在调整其他潜在预后因素后，多因素分析进一步证实了这一点。在评估打算接受微波消融治疗结直肠癌肝转移的患者的疾病进展时，应考虑基于原发肿瘤位置的分层。
Thermal ablation has been considered as an alternative for local curative intent in patients with unresectable colorectal liver metastases. The influence of primary tumor location on the prognosis of colorectal liver metastases patients who have undergone microwave ablation has yet to be determined. We reviewed 295 patients who underwent microwave ablation for colorectal liver metastases at our institution between March 2006 and March 2016. Univariate and multivariate analyses were performed to identify predictors of overall and progression-free survival. Technical success was achieved in 96.6% of patients (n = 289), with a post-procedural complication rate of 2.0% (n = 6). After a median follow-up of 24 (range, 2–86) months, comparable overall survival rates (p = 0.583) were observed in patients with different primary tumor locations. Patients with colorectal liver metastases originating from left-sided primary colon cancer exhibited a better progression-free survival than patients whose colorectal liver metastases had originated from right-sided primary colon cancer (hazard ratio: 0.67, 95.0% confidence interval: 0.48–0.94; p = 0.012), which was further confirmed in a multivariate analysis after adjustment for other potential prognostic factors. Stratification based on primary tumor location should be taken into consideration in the assessment of disease progression in patients who intend to undergo microwave ablation for colorectal liver metastases.