Solbiati L, Livraghi T, Goldberg S N, Ierace T, Meloni F, Dellanoce M, Cova L, Halpern E F, Gazelle G S
Department of Radiology, Ospedale Generale, Busto Arsizio, Italy.
Radiology. 2001 Oct;221(1):159-66. doi: 10.1148/radiol.2211001624.
To describe the results of an ongoing radio-frequency (RF) ablation study in patients with hepatic metastases from colorectal carcinoma.
In 117 patients, 179 metachronous colorectal carcinoma hepatic metastases (0.9-9.6 cm in diameter) were treated with RF ablation by using 17-gauge internally cooled electrodes. Computed tomographic follow-up was performed every 4-6 months. Recurrent tumors were retreated when feasible. Time to new metastases and death for each patient and time to local recurrence for individual lesions were modeled with Kaplan-Meier analysis. Modeling determined the effect of number of metastases on the time to new metastases and death and effect of tumor size on local recurrence.
Estimated median survival was 36 months (95% CI; 28, 52 months). Estimated 1, 2, and 3-year survival rates were 93%, 69%, and 46%, respectively. Survival was not significantly related to number of metastases treated. In 77 (66%) of 117 patients, new metastases were observed at follow-up. Estimated median time until new metastases was 12 months (95% CI; 10, 18 months). Percentages of patients with no new metastases after initial treatment at 1 and 2 years were 49% and 35%, respectively. Time to new metastases was not significantly related to number of metastases. Seventy (39%) of 179 lesions developed local recurrence after treatment. Of these, 54 were observed by 6 months and 67 by 1 year. No local recurrence was observed after 18 months. Frequency and time to local recurrence were related to lesion size (P < or =.001).
RF ablation is an effective method to treat hepatic metastases from colorectal carcinoma.
描述一项正在进行的针对结直肠癌肝转移患者的射频消融研究结果。
117例患者共179处异时性结直肠癌肝转移灶（直径0.9 - 9.6厘米），使用17G内冷电极进行射频消融治疗。每4 - 6个月进行一次计算机断层扫描随访。可行时对复发性肿瘤进行再次治疗。采用Kaplan-Meier分析对每位患者出现新转移灶和死亡的时间以及单个病灶局部复发的时间进行建模。建模确定转移灶数量对出现新转移灶和死亡时间的影响以及肿瘤大小对局部复发的影响。
估计中位生存期为36个月（95%可信区间：28, 52个月）。估计1年、2年和3年生存率分别为93%、69%和46%。生存率与治疗的转移灶数量无显著相关性。117例患者中有77例（66%）在随访时出现新转移灶。估计出现新转移灶的中位时间为12个月（95%可信区间：10, 18个月）。初始治疗后1年和2年无新转移灶的患者百分比分别为49%和35%。出现新转移灶的时间与转移灶数量无显著相关性。179处病灶中有70处（39%）治疗后出现局部复发。其中，54处在6个月时被观察到，67处在1年时被观察到。18个月后未观察到局部复发。局部复发频率和时间与病灶大小相关（P≤0.001）。
射频消融是治疗结直肠癌肝转移的有效方法。
