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葡萄膜黑色素瘤肝转移灶的射频消融与手术切除

Radiofrequency ablation and surgical resection of liver metastases from uveal melanoma.

作者信息

Mariani P, Almubarak M M, Kollen M, Wagner M, Plancher C, Audollent R, Piperno-Neumann S, Cassoux N, Servois V

机构信息

Department of Surgical Oncology, Institut Curie, 26 rue d'Ulm-75248, Paris Cedex 05, France.

Department of Surgical Oncology, Institut Curie, 26 rue d'Ulm-75248, Paris Cedex 05, France.

出版信息

Eur J Surg Oncol. 2016 May;42(5):706-12. doi: 10.1016/j.ejso.2016.02.019. Epub 2016 Feb 23.

Abstract

BACKGROUND

The resection of liver metastasis from uveal melanoma (LMUM) remains controversial. In this study, we evaluated treatment with radiofrequency ablation (RFA) for liver metastases alone or in combination with surgical liver resection.

METHODS

A total of 72 patients with LMUM were evaluated in this study. Of these, 57 patients underwent surgical resection (S) while 15 patients had RFA ± S. Clinicopathologic factors were evaluated in terms of recurrence and survival using Chi-square and log-rank tests, respectively.

RESULTS

We studied 22 metastases treated by RFA. There were no statistically significant differences between the groups in terms of median age of onset, synchronous nature of the metastases, time from primary tumour treatment to liver metastasis, diameter of the largest metastasis, presence of liver miliary disease, and the type of liver resection. There was a statistically lower number of liver metastases and more bilobar metastases in the RFA group than in the S group. The median overall survival after liver surgery was 27 months in group S and 28 months in the RFA group ± S. The median disease-free survival was 10 months in group S and 7 months in the RFA group ± S. There were no statistically significant differences in the median overall survival and disease-free survival between groups.

CONCLUSIONS

The results of this retrospective analysis show that RFA can be used to treat liver metastases to spare the hepatic parenchyma. RFA ± liver surgery and liver surgery alone demonstrate similar survival times.

摘要

背景

葡萄膜黑色素瘤肝转移灶(LMUM)的切除仍存在争议。在本研究中,我们评估了单独使用射频消融(RFA)或联合肝手术切除治疗肝转移的效果。

方法

本研究共评估了72例LMUM患者。其中,57例患者接受了手术切除(S),15例患者接受了RFA±S。分别使用卡方检验和对数秩检验从复发和生存方面评估临床病理因素。

结果

我们研究了22个接受RFA治疗的转移灶。两组在发病年龄中位数、转移灶的同步性、从原发性肿瘤治疗到肝转移的时间、最大转移灶直径、肝粟粒样病变的存在以及肝切除类型方面无统计学显著差异。RFA组的肝转移灶数量在统计学上低于S组,且双叶转移灶更多。肝手术后S组的中位总生存期为27个月,RFA组±S为28个月。S组的无病生存期中位数为10个月,RFA组±S为7个月。两组之间的中位总生存期和无病生存期无统计学显著差异。

结论

这项回顾性分析的结果表明,RFA可用于治疗肝转移以保留肝实质。RFA±肝手术和单纯肝手术的生存时间相似。

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