Guo Y L, Tong Z H, Xu X, Zhao Y, Liu J W, Wang H G, Dong G L
Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2017 Mar 28;97(12):925-928. doi: 10.3760/cma.j.issn.0376-2491.2017.12.010.
To compare the efficacy and safety of colorectal resection combined with simultaneous radiofrequency ablation (RFA) in the treatment of synchronous colorectal liver metastases(SCRLM). This retrospective study involved the patients admitted between January 1st 2010 and September 1st 2013. A total of 20 patients who underwent colorectal resection combined with simultaneous RFA of SCRLM were enrolled. Those patients (RFA group) were matched with 20 patients (Resection group) who underwent simultaneous resections of colorectal cancer and SCRLM based on the propensity scores. Perioperative parameters and survival outcomes were compared between the two groups. The RFA and Resection groups were comparable in demographics, cancer characteristics and chemotherapy treatment (all >0.05). The estimated blood loss and intraoperative blood transfusions in the RFA group were significantly lower than those in the resection group [150.00(100.00-200.00) vs 200.00(112.50-650.00), 1 vs 7, all >0.05]. The postoperative stay in the RFA group was significantly shorter than that in laparoscopic group [8.50(8.00-10.75) vs 11.00(8.25-14.25), =0.043]. There was no significant difference in postoperative complications (>0.05). The 3-year disease free survival rate was 14.00% in the RFA group, and 31.20% in the Resection group (=0.047). However, the 3-year overall rates were similar between the two groups (>0.05). Compared with simultaneous resections of colorectal cancer and SCRLM resections, colorectal resection combined with simultaneous RFA of SCRLM was associated with less surgical blood loss and shorter hospitalization. Although inferior to simultaneous resections of colorectal cancer and SCRLM resections in survival outcomes, this approach extends the capability of delivering potentially curative treatment for colorectal cancer patients with unresectable SCRLM.
比较结直肠切除术联合同期射频消融（RFA）治疗同时性结直肠癌肝转移（SCRLM）的疗效和安全性。这项回顾性研究纳入了2010年1月1日至2013年9月1日期间收治的患者。共有20例行结直肠切除术联合同期SCRLM的RFA患者入组。这些患者（RFA组）与20例基于倾向评分同时行结直肠癌和SCRLM切除术的患者（切除组）进行匹配。比较两组的围手术期参数和生存结果。RFA组和切除组在人口统计学、癌症特征和化疗治疗方面具有可比性（均>0.05）。RFA组的估计失血量和术中输血次数显著低于切除组[150.00（100.00 - 200.00） vs 200.00（112.50 - 650.00），1 vs 7，均>0.05]。RFA组的术后住院时间显著短于腹腔镜组[8.50（8.00 - 10.75） vs 11.00（8.25 - 14.25），=0.043]。术后并发症无显著差异（>0.05）。RFA组的3年无病生存率为14.00%，切除组为31.20%（=0.047）。然而，两组的3年总生存率相似（>0.05）。与同时行结直肠癌和SCRLM切除术相比，结直肠切除术联合同期SCRLM的RFA手术失血量更少，住院时间更短。尽管在生存结果方面不如同时行结直肠癌和SCRLM切除术，但这种方法扩展了为不可切除SCRLM的结直肠癌患者提供潜在治愈性治疗的能力。
