Department of General and Hepatobiliary Surgery, University Hospital Aintree, Longmoor Lane, Liverpool L69 3GA, United Kingdom.
Eur J Surg Oncol. 2013 Aug;39(8):844-9. doi: 10.1016/j.ejso.2013.04.005. Epub 2013 Jun 14.
Ablation with or without resection for colorectal liver metastases has been suggested as a potential method of improving survival if complete surgical resection is not possible. This study assessed the safety and efficacy of surgical microwave ablation (MWA) with or without resection for colorectal liver metastases.
A retrospective case series was reviewed. Data was extracted for all patients treated with open MWA with or without resection for colorectal liver metastases. Endpoints included postoperative 30-day morbidity and mortality, local treatment failure, disease free survival and overall survival.
A total of 43 patients with technically irresectable disease were treated with MWA; 28 underwent combined MWA and resection, whilst 15 underwent MWA as the sole treatment modality. Overall post-operative morbidity was 35%, 30-day postoperative mortality 2%. At a median follow-up of 15 months, local treatment failure was observed in 4% of ablated lesions. 3-year OS was 36% for MWA group, compared to 45% for the combined ablate/resect group with 3-year DFS of 32% and 8% respectively.
Microwave ablation with or without resection is a safe and effective method of achieving local disease control. Ablation with or without resection is associated with good long-term outcomes, and may be a suitable treatment option for small non-resectable colorectal liver metastases.
对于无法进行完全手术切除的结直肠肝转移患者,消融联合或不联合切除术可能是一种提高生存的潜在方法。本研究评估了开放手术微波消融(MWA)联合或不联合切除术治疗结直肠肝转移的安全性和有效性。
回顾性病例系列研究。对所有接受开放 MWA 联合或不联合切除术治疗的结直肠肝转移患者的数据进行了提取。终点包括术后 30 天发病率和死亡率、局部治疗失败、无疾病生存和总生存。
共有 43 例技术上无法切除的患者接受了 MWA 治疗;28 例联合 MWA 和切除术,15 例单独接受 MWA 治疗。总的术后发病率为 35%,30 天术后死亡率为 2%。在中位随访 15 个月时,消融病变中观察到 4%的局部治疗失败。MWA 组的 3 年 OS 为 36%,联合消融/切除术组为 45%,3 年无病生存率分别为 32%和 8%。
MWA 联合或不联合切除术是一种安全有效的局部疾病控制方法。消融联合或不联合切除术与良好的长期结果相关,可能是治疗小的不可切除结直肠肝转移的一种合适的治疗选择。