Yan Tristan D, King Julie, Sjarif Adrian, Glenn Derek, Steinke Karin, Morris David L
Department of Surgery, University of New South Wales, St. George Hospital, Sydney, New South Wales, 2217, Australia.
Ann Surg Oncol. 2006 Nov;13(11):1529-37. doi: 10.1245/s10434-006-9101-1. Epub 2006 Sep 29.
Preliminary results have shown that percutaneous radiofrequency ablation (RFA) may play a useful role in patients with inoperable lung tumors. This series evaluated the prognostic features for survival in nonsurgical candidates who underwent percutaneous RFA of pulmonary metastases from colorectal carcinoma.
Fifty-five patients not suitable for surgery underwent percutaneous RFA for colorectal pulmonary metastases. All clinical and treatment-related data were collected prospectively. The primary end point of the study was overall survival, defined from the time of RFA intervention. Univariate and multivariate analyses were performed to identify statistically significant prognostic parameters for overall survival.
The overall median survival was 33 months (range, 4-40 months), with actuarial 1-, 2-, and 3-year survival of 85%, 64%, and 46%, respectively. Univariate analysis demonstrated that largest size of lung metastasis (P < .001), location of lung metastases (P = .032), and repeat percutaneous RFA for pulmonary recurrence (P = .024) were statistically significant for overall survival. Multivariate analysis demonstrated that largest size of lung metastasis >3 cm was independently associated with a reduced overall survival (P = .003).
Percutaneous lung RFA may play a useful role in nonsurgical candidates with colorectal pulmonary metastases. However, the survival benefit of this interventional procedure for patients with a pulmonary metastasis >3 cm was limited.
初步结果表明，经皮射频消融（RFA）可能对无法手术的肺癌患者发挥有益作用。本系列研究评估了接受结直肠癌肺转移灶经皮RFA的非手术候选患者的生存预后特征。
55例不适合手术的患者接受了结直肠癌肺转移灶的经皮RFA治疗。前瞻性收集所有临床和治疗相关数据。研究的主要终点为总生存期，从RFA干预时间开始计算。进行单因素和多因素分析以确定总生存期的统计学显著预后参数。
总中位生存期为33个月（范围4 - 40个月），1年、2年和3年精算生存率分别为85%、64%和46%。单因素分析表明，肺转移灶最大直径（P <.001）、肺转移灶位置（P =.032）以及因肺复发进行重复经皮RFA（P =.024）对总生存期有统计学显著意义。多因素分析表明，肺转移灶最大直径>3 cm与总生存期降低独立相关（P =.003）。
经皮肺RFA可能对结直肠癌肺转移的非手术候选患者发挥有益作用。然而，对于肺转移灶>3 cm的患者，这种介入治疗的生存获益有限。
