Frich Lars, Brabrand Knut, Aaløkken Trond Mogens, Edwin Bjørn, Gladhaug Ivar P
Kirurgisk klinikk, Rikshospitalet og Intervensjonssenteret Rikshospitalet, 0027 Oslo.
Tidsskr Nor Laegeforen. 2008 Jan 3;128(1):57-60.
Radiofrequency (RF) ablation is a method that uses electrical current for thermal destruction of solid tumours. We present our experience with RF ablation in a patient population with non-resectable colorectal liver metastases.
17 of the 23 patients with non-resectable liver metastases treated with RF ablation at Rikshospitalet University Hospital from 2003 to 2006, were included in a prospective non-randomized study with standardized follow-up.
RF ablation was used to treat one liver metastasis in each patient, and was combined with liver resection in seven patients. The median follow-up time after RF ablation was 29 months (14-55). One-year survival was 100% and survival after both two and three years was 67%. Follow-up examinations revealed local tumour progression at the RF-treated site in eight patients, intrahepatic recurrences not related to the RF-treated site in eight patients and extrahepatic recurrence in nine patients. Four patients with intrahepatic recurrence were re-treated with a curative intent.
Long-term survival is possible after RF ablation of selected patients with non-resectable colorectal liver metastases. Local tumour progression, intrahepatic- and extrahepatic tumour recurrence is common after RF ablation. Systematic follow-up can identify tumour recurrences that may be re-treated with a curative intent. Liver resection should still be considered the gold standard for patients with resectable colorectal liver metastases.
射频消融是一种利用电流对实体肿瘤进行热消融的方法。我们介绍了在一组不可切除的结直肠癌肝转移患者中进行射频消融的经验。
2003年至2006年在Rikshospitalet大学医院接受射频消融治疗的23例不可切除肝转移患者中,17例被纳入一项具有标准化随访的前瞻性非随机研究。
每位患者均采用射频消融治疗一处肝转移灶,7例患者同时接受了肝切除术。射频消融后的中位随访时间为29个月(14 - 55个月)。1年生存率为100%,2年和3年生存率均为67%。随访检查发现,8例患者在射频治疗部位出现局部肿瘤进展,8例患者出现与射频治疗部位无关的肝内复发,9例患者出现肝外复发。4例肝内复发患者接受了旨在治愈的再次治疗。
对部分不可切除的结直肠癌肝转移患者进行射频消融后有可能实现长期生存。射频消融后局部肿瘤进展、肝内和肝外肿瘤复发很常见。系统随访可发现可能接受旨在治愈的再次治疗的肿瘤复发情况。对于可切除的结直肠癌肝转移患者,肝切除术仍应被视为金标准。