Shamimi-Noori Susan, Gonsalves Carin F, Shaw Colette M
Division of Interventional Radiology, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Semin Intervent Radiol. 2017 Jun;34(2):145-166. doi: 10.1055/s-0037-1602712. Epub 2017 Jun 1.
Metastatic liver disease is a major cause of cancer-related morbidity and mortality. Surgical resection is considered the only curative treatment, yet only a minority is eligible. Patients who present with unresectable disease are treated with systemic agents and/or locoregional therapies. The latter include thermal ablation and catheter-based transarterial interventions. Thermal ablation is reserved for those with limited tumor burden. It is used to downstage the disease to enable curative surgical resection, as an adjunct to surgery, or in select patients it is potentially curative. Transarterial therapies are indicated in those with more diffuse disease. The goals of care are to palliate symptoms and prolong survival. The indications and supporting data for thermal ablation and transarterial interventions are reviewed, technical and tumor factors that need to be considered prior to intervention are outlined, and finally several cases are presented.
转移性肝病是癌症相关发病和死亡的主要原因。手术切除被认为是唯一的治愈性治疗方法，但只有少数患者适合。出现不可切除疾病的患者接受全身治疗和/或局部区域治疗。后者包括热消融和基于导管的经动脉介入治疗。热消融适用于肿瘤负荷有限的患者。它用于降低疾病分期以实现根治性手术切除，作为手术的辅助手段，或者在某些患者中可能具有治愈性。经动脉治疗适用于疾病更广泛的患者。护理目标是缓解症状和延长生存期。本文回顾了热消融和经动脉介入治疗的适应症及支持数据，概述了干预前需要考虑的技术和肿瘤因素，最后展示了几个病例。
