Babawale Simeon Niyi, Jensen Thomas Mandøe, Frøkjær Jens Brøndum
Simeon Niyi Babawale, Thomas Mandøe Jensen, Jens Brøndum Frøkjær, Department of Radiology, Aalborg University Hospital, DK-9000 Aalborg, Denmark.
World J Gastrointest Surg. 2015 Mar 27;7(3):33-8. doi: 10.4240/wjgs.v7.i3.33.
To retrospectively evaluate the long-term survival of patients that received radiofrequency ablation (RFA) therapies of colorectal liver metastases.
In 2005 to 2008, RFA of 105 colorectal liver metastases (CRLM) were performed on 49 patients in our institution. The liver metastases were evaluated, both before and after ablation therapies, with contrast enhanced computerised tomography and contrast enhanced ultrasonography. Histological evidence of malignant liver metastases was obtained in the few instances where contrast enhanced ultrasonography gave equivocal results. Accesses to the CRLM were guided ultrasonically in all patients. The data obtained from records of these ablations were retrospectively analysed and survival data were compared with existing studies in the literature.
1-, 2-, 3-, 4- and 5-year survival rates, when no stringent selection criteria were applied, were 92%, 65%, 51%, 41% and 29% respectively. To explore the impact of the number and size of CRLM on patients' survival, an exclusion of 13 patients (26.5%) with number of CRLM ≥ 5 and tumour size ≥ 40 mm resulted in 1-, 2-, 3-, 4- and 5-year survival rates improving to 94%, 69%, 53%, 42% and 31% respectively. It is of note that 9 of 49 patients developed extra-hepatic metastases, not visible or seen on pre-treatment scans, just after RFA treatment. These patients had poorer survival. The development of extra-hepatic metastases in nearly 20% of the patients included in our study can partly account for modestly lower survival rates as compared with earlier studies in the literature.
Our study underscores the fact that optimum patients' selection before embarking on RFA treatment is vitally important to achieving a superior outcome.
回顾性评估接受结直肠癌肝转移射频消融（RFA）治疗患者的长期生存率。
2005年至2008年，我院对49例患者的105处结直肠癌肝转移灶进行了RFA治疗。在消融治疗前后，采用对比增强计算机断层扫描和对比增强超声对肝转移灶进行评估。在少数对比增强超声结果不明确的情况下，获取了恶性肝转移的组织学证据。所有患者均在超声引导下对结直肠癌肝转移灶进行穿刺。对这些消融记录所获得的数据进行回顾性分析，并将生存数据与文献中的现有研究进行比较。
在未应用严格选择标准时，1年、2年、3年、4年和5年生存率分别为92%、65%、51%、41%和29%。为探究结直肠癌肝转移灶的数量和大小对患者生存的影响，排除13例（26.5%）结直肠癌肝转移灶数量≥5个且肿瘤大小≥40 mm的患者后，1年、2年、3年、4年和5年生存率分别提高至94%、69%、53%、42%和31%。值得注意的是，49例患者中有9例在RFA治疗后不久出现了肝外转移，这些转移灶在治疗前的扫描中不可见或未被发现。这些患者的生存率较低。在我们纳入研究的近20%的患者中出现肝外转移，这在一定程度上可以解释与文献中早期研究相比生存率略低的原因。
我们的研究强调了在进行RFA治疗前进行最佳患者选择对于取得更好疗效至关重要这一事实。
