a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China.
b Department of Oncology , Chinese PLA General Hospital , Beijing , China.
Int J Hyperthermia. 2017 Nov;33(7):830-835. doi: 10.1080/02656736.2017.1306120. Epub 2017 Mar 29.
The resection rate for liver metastases from gastric cancer is only 1.4-21.1%. This study aimed to evaluate the safety and therapeutic efficacy of microwave ablation (MWA) for liver metastases from gastric adenocarcinoma (LMGC).
A database of 108 gastric adenocarcinoma patients with liver metastases who underwent MWA (n = 32) or systemic chemotherapy (n = 76) for LMGC between 2008 and 2016 was reviewed. Overall survival curves were assessed and compared based on different therapies.
All the patients were followed up for a median of 15 months (range, 2-68 months). The median cumulative survival times of patients after MWA and systemic chemotherapy were 25 (95% confidence interval (CI) 16.5-33.5) months and 12 (95% CI 7.7-16.3) months, respectively (HR 1.751, 95% CI 1.077-2.845; p = .015). The 1-, 3-, and 5- year survival rates were 80.9%, 31.2%, and 16.7% (MWA group); and 50.0%, 18.8%, and 5.4% (chemotherapy group), respectively. In the MWA group, side effects were reported in eight patients who developed abdominal pain, transient fever, or nausea. Dominant size, number of liver metastases, therapeutic modalities, and presence of extrahepatic metastases showed significant prognostic value in univariate analyses; while the latter three were identified as independent prognostic factors in multivariate regression analysis.
MWA is a safe and useful alternative for liver metastases from gastric adenocarcinoma in selected patients.
胃癌肝转移的切除率仅为 1.4-21.1%。本研究旨在评估微波消融（MWA）治疗胃腺癌肝转移（LMGC）的安全性和疗效。
回顾了 2008 年至 2016 年间接受 MWA（n=32）或全身化疗（n=76）治疗的 108 例胃腺癌伴肝转移患者的数据库。根据不同的治疗方法评估和比较总生存曲线。
所有患者的中位随访时间为 15 个月（范围 2-68 个月）。MWA 和全身化疗后患者的中位累积生存时间分别为 25（95%置信区间（CI）16.5-33.5）个月和 12（95% CI 7.7-16.3）个月（HR 1.751，95% CI 1.077-2.845；p=0.015）。1、3 和 5 年生存率分别为 80.9%、31.2%和 16.7%（MWA 组）；50.0%、18.8%和 5.4%（化疗组）。在 MWA 组中，有 8 例患者出现腹痛、短暂发热或恶心等不良反应。单因素分析显示，肿瘤最大径、肝转移灶数目、治疗方式和肝外转移存在与预后显著相关；多因素回归分析显示，后三者为独立预后因素。
MWA 是治疗胃腺癌肝转移的一种安全有效的方法，适用于特定患者。
