Huang Z, Li K Y, Zhou P P, Wu X B, Li S S
Department of Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Yi Xue Za Zhi. 2020 Mar 10;100(9):696-701. doi: 10.3760/cma.j.issn.0376-2491.2020.09.010.
To study the clinical efficacy of ultrasound-guided percutaneous microwave ablation and surgical resection for liver metastases from colorectal cancer. Retrospective analysis of 184 patients with liver metastases from colorectal cancer in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2012 to June 2017.Percutaneous microwave ablation or surgical resection for liver metastases were selected under ultrasound guidance. Subgroup analysis was performed according to the treatment of liver metastases. There were 98 patients in the microwave-only group (56 males and 42 females, aged (59±11) years) and 86 cases in the surgery-only group (56 males and 30 females, aged (56±11) years). The baseline data of the two groups were compared, and the results showed that the size of the metastatic lesions in the microwave-only group was smaller than that in the surgery-only group, and the remaining data didn't had statistical differences.The survival time of the two groups of patients was analyzed separately.According to the size of the metastases, the metastases were divided into groups with a diameter of<3 cm and a group of ≥3 cm. The survival time of patients in the microwave-only group and the surgery-only group were analyzed respectively.According to the different primary tumor grades of colorectal cancer, the survival time of patients in the simple microwave-only group and the surgery-only group in the primary tumors Duck A, Duck B, and Duck C were analyzed. In the microwave-only group, the overall survival rates at 1, 3, and 5 years were 100%, 50.9%, and 20.9%; in the surgery-only group, the overall survival rates at 1, 3, and 5 years were 100%, 42.8%, and 20.8%, respectively. There was no significant difference in overall survival between the groups (0.972).Metastatic focus diameter ≥3 cm: the overall survival rates of 1, 3, and 5 years with microwave-only were 100%, 65.4%, and 12.1%; the overall survival rates of 1, 3, and 5 years with surgery-only were 100%, 59.5%, and 30.9%. There was no significant difference in overall survival between the groups (0.067). The long-term survival rate of the surgery-only group was greater than that of the microwave-only group (0.018).Metastasis diamete3 cm: there was no significant difference in overall survival between the surgery-only group and the microwave-only group (0.103).In the treatment of Duck B and C liver metastases of primary colorectal cancer, there was no significant difference in overall survival between microwave alone and surgery alone (0.376, 0.385).Multivariate analysis showed that the size of colorectal cancer metastases was an independent risk factor affecting the prognosis of patients with colorectal cancer liver metastases. Percutaneous microwave ablation has a good effect on colorectal cancer liver metastases and has a similar survival prognosis as surgery.For livers with color ≥ 3 cm in colorectal cancer, the long-term survival rate of the surgery-only group is greater than that of the microwave-only group.
研究超声引导下经皮微波消融术与手术切除治疗结直肠癌肝转移的临床疗效。回顾性分析2012年1月至2017年6月在华中科技大学同济医学院附属同济医院就诊的184例结直肠癌肝转移患者。在超声引导下选择对肝转移灶进行经皮微波消融或手术切除。根据肝转移灶的治疗方式进行亚组分析。单纯微波组98例(男56例,女42例,年龄(59±11)岁),单纯手术组86例(男56例,女30例,年龄(56±11)岁)。比较两组的基线资料,结果显示单纯微波组转移瘤大小小于单纯手术组,其余资料无统计学差异。分别分析两组患者的生存时间。根据转移灶大小,将转移灶分为直径<3 cm组和≥3 cm组,分别分析单纯微波组和单纯手术组患者的生存时间。根据结直肠癌不同的原发肿瘤分级,分析原发肿瘤Duck A、Duck B和Duck C级单纯微波组和单纯手术组患者的生存时间。单纯微波组1、3、5年总生存率分别为100%、50.9%、20.9%;单纯手术组1、3、5年总生存率分别为100%、42.8%、20.8%。两组总生存无显著差异(0.972)。转移灶直径≥3 cm:单纯微波组1、3、5年总生存率分别为100%、65.4%、12.1%;单纯手术组1、3、5年总生存率分别为100%、59.5%、30.9%。两组总生存无显著差异(0.067)。单纯手术组长期生存率大于单纯微波组(0.018)。转移灶直径<3 cm:单纯手术组与单纯微波组总生存无显著差异(0.103)。在原发性结直肠癌Duck B和C级肝转移的治疗中,单纯微波与单纯手术总生存无显著差异(0.376, 0.385)。多因素分析显示,结直肠癌转移灶大小是影响结直肠癌肝转移患者预后的独立危险因素。经皮微波消融治疗结直肠癌肝转移效果良好,生存预后与手术相似。对于结直肠癌肝转移灶直径≥3 cm者,单纯手术组长期生存率大于单纯微波组。