Lawes D, Chopada A, Gillams A, Lees W, Taylor I
Department of Surgery, Royal Free and University College London Medical School, University College London, London UK.
Ann R Coll Surg Engl. 2006 Nov;88(7):639-42. doi: 10.1308/003588406X149129.
Patients with liver metastasis from breast cancer have a poor prognosis, although this may be improved by hepatectomy in a selected group with disease confined to the liver. We evaluate the effectiveness of radiofrequency ablation (RFA) as a cytoreductive strategy in the management of liver metastasis from primary breast cancer.
Nineteen patients with hepatic metastasis from primary breast cancer underwent RFA of their liver lesions between April 1998 and August 2004.
The median age of the patients was 52 years (range, 32-69 years), 8 had disease confined to the liver, with 11 having stable extrahepatic disease in addition. Seven patients with disease confined to the liver at presentation are alive, as are 6 with extrahepatic disease, median follow-up after RFA was 15 months (range, 0-77 months). Survival at 30 months was 41.6%. In addition, 7 patients followed up for a median of 14 months (range, 2-29 months) remain alive and disease-free. RFA failed to control hepatic disease in 3 patients. RFA was not associated with any mortality or major morbidity.
Control of hepatic metastasis from breast cancer is possible using RFA and may lead to a survival benefit, particularly in those patients with disease confined to the liver.
乳腺癌肝转移患者预后较差,尽管在疾病局限于肝脏的特定患者群体中,肝切除术可能会改善预后。我们评估了射频消融(RFA)作为一种减瘤策略在原发性乳腺癌肝转移治疗中的有效性。
1998年4月至2004年8月期间,19例原发性乳腺癌肝转移患者接受了肝脏病变的RFA治疗。
患者的中位年龄为52岁(范围32 - 69岁),8例患者疾病局限于肝脏,另外11例患者伴有稳定的肝外疾病。7例初诊时疾病局限于肝脏的患者存活,6例伴有肝外疾病的患者也存活,RFA后的中位随访时间为15个月(范围0 - 77个月)。30个月时的生存率为41.6%。此外,7例中位随访14个月(范围2 - 29个月)的患者仍存活且无疾病。3例患者RFA未能控制肝脏疾病。RFA未导致任何死亡或严重并发症。
使用RFA可以控制乳腺癌肝转移,可能带来生存获益,特别是对于那些疾病局限于肝脏的患者。