Leen Edward, Horgan Paul G
Department of Surgery and Radiology, Royal Infirmary, Glasgow, Scotland, UK.
Surg Oncol. 2007 Jul;16(1):47-51. doi: 10.1016/j.suronc.2007.04.004. Epub 2007 May 11.
RFA of liver metastases is promising despite variable results. The differences in reported success rates may be explained by the difference in tumour types/vascularity/aggressiveness, patient selection, operator's expertise and the equipment used. Current limits relate to the small volume of consistent ablation that can be achieved with current equipment. Further technical refinements yielding more reliable ablation with larger surgical margin may reduce local recurrence rate. Although numerous studies have shown effective treatment responses after RFA, the precise impact of RFA on survival of colorectal cancer patients with liver metastases remains unclear. Resection remains the gold standard for patients with liver metastases. In patients with limited number of unresectable lesions and in cases, which are unresectable on the basis of lesional number and localization, RFA is an attractive approach to obtain tumour clearance. Randomised control trials evaluating the value of combined adjuvant systemic chemotherapy are still urgently needed.
尽管结果存在差异，但肝转移瘤的射频消融术仍颇具前景。报告的成功率差异可能由肿瘤类型/血管分布/侵袭性、患者选择、操作者的专业技能以及所使用的设备不同所导致。目前的局限性在于现有设备所能实现的一致性消融体积较小。进一步的技术改进，以实现更大手术切缘的更可靠消融，可能会降低局部复发率。尽管众多研究已表明射频消融术后有有效的治疗反应，但射频消融术对结直肠癌肝转移患者生存的确切影响仍不明确。手术切除仍是肝转移患者的金标准。对于不可切除病灶数量有限的患者，以及基于病灶数量和位置不可切除的病例，射频消融术是实现肿瘤清除的一种有吸引力的方法。仍迫切需要进行随机对照试验来评估辅助性全身化疗联合应用的价值。
