Hiraki Takao, Gobara Hideo, Iishi Tatsuhiko, Sano Yoshifumi, Iguchi Toshihiro, Fujiwara Hiroyasu, Tajiri Nobuhisa, Sakurai Jun, Date Hiroshi, Mimura Hidefumi, Kanazawa Susumu
Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan.
J Vasc Interv Radiol. 2007 Oct;18(10):1264-9. doi: 10.1016/j.jvir.2007.06.027.
To retrospectively evaluate the midterm outcomes (eg, safety, local efficacy, and survival) after radiofrequency (RF) ablation for pulmonary metastases from colorectal cancer.
Twenty-seven patients (19 men and eight women; mean age, 61.6 years) with 49 pulmonary metastases (mean long axis diameter, 1.5 cm) from colorectal cancer underwent 41 percutaneous computed tomography (CT)-guided RF ablation sessions. Follow-up examinations were performed with CT by using contrast medium administration in all patients; positron emission tomography was performed in five patients. The safety of the procedure, local tumor control, and patient survival were evaluated. Multiple variables were analyzed to determine prognostic factors.
Pneumothorax occurred after 20 of the 41 sessions (49%), three of which necessitated chest tube placement. A small pleural effusion was found after six of the 41 sessions (15%). No major hemorrhagic event was observed. None of the patients died due to the procedure. The median follow-up period was 20.1 months (range, 11.2-47.7 months). The primary and secondary technique effectiveness rates were 72% and 85%, respectively, at 1 year, 56% and 62% at 2 years, and 56% and 62% at 3 years. The overall survival rates after RF ablation were 96% at 1 year, 54% at 2 years, and 48% at 3 years. The presence of extrapulmonary metastasis was determined to be a prognostic factor (P = .001).
The midterm outcomes of percutaneous RF ablation for colorectal pulmonary metastases appear promising. The presence of extrapulmonary metastasis had an adverse effect on survival after RF ablation.
回顾性评估经射频(RF)消融治疗结直肠癌肺转移的中期疗效(如安全性、局部疗效和生存率)。
27例(19例男性,8例女性;平均年龄61.6岁)患有49处结直肠癌肺转移灶(平均长轴直径1.5 cm)的患者接受了41次经皮计算机断层扫描(CT)引导下的RF消融治疗。所有患者均通过注射造影剂进行CT随访检查;5例患者进行了正电子发射断层扫描。评估了该治疗方法的安全性、局部肿瘤控制情况和患者生存率。分析多个变量以确定预后因素。
41次治疗中有20次(49%)发生气胸,其中3次需要放置胸管。41次治疗中有6次(15%)发现少量胸腔积液。未观察到重大出血事件。无患者因该治疗死亡。中位随访期为20.1个月(范围11.2 - 47.7个月)。1年时的初次和二次技术有效率分别为72%和85%,2年时为56%和62%,3年时为56%和62%。RF消融后的总生存率1年时为96%,2年时为54%,3年时为48%。肺外转移的存在被确定为一个预后因素(P = 0.001)。
经皮RF消融治疗结直肠癌肺转移的中期疗效似乎很有前景。肺外转移的存在对RF消融后的生存有不利影响。