Mahnken A H, Bruners P, Tacke J A, Günther R W
Klinik für Radiologische Diagnostik, Universitätsklinikum Aachen.
Dtsch Med Wochenschr. 2009 May;134(19):976-80. doi: 10.1055/s-0029-1222553. Epub 2009 Apr 28.
Data on radiofrequency ablation (RFA) of liver metastasis has not been uniform. The goal of this study was to determine medium-term success of CT-guided RFA of liver metastases from colorectal cancer.
43 consecutive patients (27 men; aged 67+/-10 years) with a total of 87 liver metastases from colo-rectal cancer were included in this retrospective analysis. All patients underwent percutaneous RFA after first- or second-line chemotherapy. The mean follow-up period was 29.8 +/- 22.7 (4 - 85) months. Overall survival and local recurrence-free survival were determined using Kaplan-Meier curves. The effects of primary therapeutic success, number of lesions, maximum lesion size and sum of lesion diameters were assessed.
In total, 83 lesions were treated during 56 interventions. Taking into account local recurrence and incomplete ablation 86.7 % of metastases were successfully ablated. The median survival was 46 months with estimated 1-, 3- and 5-year survival rates of 89.0 %, 66.2 % and 41.8 %, respectively. The median interval to hepatic tumor progression was 13 months after RFA. Survival was related to primary treatment success (p = 0.0353), number of lesions (p = 0.0050) and sum of lesion diameters (p = 0.0199).
CT-guided RFA is an effective treatment of liver metastases from colorectal cancer. These data support the use of RFA in patients considered ineligible for surgery.
关于肝转移瘤射频消融（RFA）的数据并不一致。本研究的目的是确定CT引导下对结直肠癌肝转移瘤进行RFA的中期疗效。
本回顾性分析纳入了43例连续患者（27例男性；年龄67±10岁），共有87个来自结直肠癌的肝转移瘤。所有患者在一线或二线化疗后接受了经皮RFA。平均随访期为29.8±22.7（4 - 85）个月。采用Kaplan-Meier曲线确定总生存期和局部无复发生存期。评估了初次治疗成功、病灶数量、最大病灶大小和病灶直径总和的影响。
在56次干预中共治疗了83个病灶。考虑到局部复发和不完全消融，86.7%的转移瘤被成功消融。中位生存期为46个月，估计1年、3年和5年生存率分别为89.0%、66.2%和41.8%。RFA后肝肿瘤进展的中位间隔时间为13个月。生存期与初次治疗成功（p = 0.0353）、病灶数量（p = 0.0050）和病灶直径总和（p = 0.0199）有关。
CT引导下RFA是治疗结直肠癌肝转移瘤的有效方法。这些数据支持在被认为不适合手术的患者中使用RFA。
