Kulkarni Suyash, Shetty Nitin S, Polnaya Ashwin M, Patil Sushil, Gala Kunal, Chivate Rahul, Ostwal Vikas, Ramaswamy Anant, Shrikhande Shailesh V, Goel Mahesh, Patkar Shraddha, Bhandare Manish, Rangarajan Venkatesh, Nilendu Purandare
Department of Radio-diagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India.
Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Radiol Imaging. 2017 Apr-Jun;27(2):200-206. doi: 10.4103/ijri.IJRI_24_17.
The study was carried out to evaluate the early outcomes using Radiofrequency Ablation (RFA) for unresectable liver metastases in the management of metastatic colorectal cancer (mCRC) from an area of low endemicity.
60 Patients with unresectable colorectal liver metastases had undergone 88 sessions of RFA from January 2007 till December 2013. The results were retrospectively analysed to evaluate the outcomes in terms of efficacy and survival rates.
The median follow up of patients in our series was 24.8months. 35/52 (67.3%) patients had complete response at 3 months while 8 patients were lost to follow up. Of the 17 patients who had recurrence, 4 (23.5%) were at the ablated site while 13 patients (76.4%) progressed elsewhere. Abdominal pain was commonest post procedural symptom (20%). There was no procedure related mortality or any major complications. Mean disease free interval and Progression free survival was 6.7 and 13.1 months. Estimated median survival in patients with liver limited disease and those with small lesion (<3cm) was 3.79 years and 3.45 years respectively. Median survival in patients with lesion size 3-5 cms was 1.5 years. Annual survival rates would be 94.5%, 55.2% and 26.2% for 1, 3 and 5 years.
Radiofrequency ablation of unresectable liver metastases is effective in treatment of mCRC. Estimated survival rates and Annual survival rates at our institute from the low endemic region also follow the global trend. Size of the lesion was an important predictor of efficacy of RFA. Presence of extrahepatic disease and lesion size >3 cm was associated with decreased survival.
本研究旨在评估在低发病率地区，使用射频消融（RFA）治疗不可切除的肝转移瘤在转移性结直肠癌（mCRC）管理中的早期疗效。
2007年1月至2013年12月，60例患有不可切除的结直肠癌肝转移患者接受了88次RFA治疗。对结果进行回顾性分析，以评估疗效和生存率方面的结果。
我们系列患者的中位随访时间为24.8个月。52例患者中有35例（67.3%）在3个月时达到完全缓解，8例患者失访。在17例复发患者中，4例（23.5%）在消融部位复发，13例（76.4%）在其他部位进展。腹痛是最常见的术后症状（20%）。没有与手术相关的死亡或任何重大并发症。平均无病生存期和无进展生存期分别为6.7个月和13.1个月。肝局限性疾病患者和小病灶（<3cm）患者的估计中位生存期分别为3.79年和3.45年。病灶大小为3 - 5厘米的患者中位生存期为1.5年。1年、3年和5年的年生存率分别为94.5%、55.2%和26.2%。
射频消融不可切除的肝转移瘤对mCRC治疗有效。我们研究所来自低发病率地区的估计生存率和年生存率也遵循全球趋势。病灶大小是RFA疗效的重要预测指标。肝外疾病的存在和病灶大小>3 cm与生存率降低相关。
