Enomoto Masanobu, Tago Tomoya, Kasahara Kenta, Wada Takahiro, Matsudo Takaaki, Murakoshi Yusuke, Ishizaki Tetsuo, Kasuya Kazuhiko, Katsumata Kenji, Tsuchida Akihiko
Dept. of Gastrointestinal and Pediatric Surgery, Tokyo Medical University.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1449-1451.
We evaluated hepatectomy combined with radiofrequency ablation(RFA)in patients with liver metastases from colorectal cancer for which curative resection is difficult.
This study included 13 patients who underwent hepatectomy combined with RFA for liver metastases from colorectal cancer in or before 2015.
In 11 patients who were determined to have achieved a complete curative resection, the 50%survival time was 35.4 months, and the 5-year overall survival (OS)rate was 33%. Recurrence at the RFA site was observed in 4 patients. There were 2 patients with a long-term survival of 5-years or longer. The reasons for concomitant use of RFA include deviation from the Makuuchi criteria in 4 patients, control of disease progression in 3 patients, non-curative surgery in 2 patients, difficulty in performing surgical procedures in 2 patients, and refusal by 1 patient, while the reason was unknown in 1 patient.
Hepatectomy combined with RFA was selected in patients in whom curative hepatectomy was impossible. Although their 5-year OS rate was lower than that of patients who undergo hepatectomy alone, local control was relatively favorable.
These results suggest that hepatectomy combined with RFA for liver metastases from colorectal cancer might be effective in selected cases.
我们评估了肝切除术联合射频消融（RFA）治疗难以进行根治性切除的结直肠癌肝转移患者的效果。
本研究纳入了2015年及以前接受肝切除术联合RFA治疗结直肠癌肝转移的13例患者。
在11例被判定为实现了根治性完全切除的患者中，50%生存时间为35.4个月，5年总生存率（OS）为33%。4例患者在RFA部位出现复发。有2例患者长期生存达5年或更长时间。联合使用RFA的原因包括4例不符合幕内标准、3例控制疾病进展、2例手术未达到根治、2例手术操作困难、1例患者拒绝，1例原因不明。
对于无法进行根治性肝切除的患者选择肝切除术联合RFA。虽然他们的5年OS率低于单纯接受肝切除术的患者，但局部控制相对良好。
这些结果表明，结直肠癌肝转移患者行肝切除术联合RFA在某些特定病例中可能有效。
