Department of Diagnostic and Interventional Radiology, Institute of Oncology, St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK.
University of Leeds, Woodhouse, Leeds, LS2 9JT, UK.
Cardiovasc Intervent Radiol. 2020 Dec;43(12):1900-1907. doi: 10.1007/s00270-020-02623-1. Epub 2020 Aug 18.
To evaluate the long-term outcome of image-guided radiofrequency ablation (RFA) when treating histologically confirmed colorectal lung metastasis in terms of overall survival (OS), progression-free survival (PFS) and local tumour control (LTC).
Retrospective single-centre study. Consecutive RFA treatments of histologically proven lung colorectal metastases between 01/01/2008 and 31/12/14. The primary outcome was patient survival (OS and PFS). Secondary outcomes were local tumour progression (LTP) and complications. Prognostic factors associated with OS/ PFS were determined by univariate and multivariate analyses.
Sixty patients (39 males: 21 females; median age 69 years) and 125 colorectal lung metastases were treated. Eighty percent (n = 48) also underwent lung surgery for lung metastases. Mean metastasis size (cm) was 1.4 ± 0.6 (range 0.3-4.0). Median number of RFA sessions was 1 (1-4). During follow-up (median 45.5 months), 45 patients died (75%). The estimated OS and PFS survival rates at 1, 3, 5, 7, 9 years were 96.7%, 74.7%, 44.1%, 27.5%, 16.3% (median OS, 52 months) and 66.7%, 31.2%, 25.9%, 21.2% and 5.9% (median PFS, 19 months). The LTC rate was 90% with 6 patients developing LTP with 1-, 2-, 3- and 4-year LTP rates of 3.3%, 8.3%, 10.0% and 10.0%. Progression-free interval < 1 year (P = 0.002, HR = 0.375) and total number of pulmonary metastases (≥ 3) treated (P = 0.037, HR = 0.480) were independent negative prognostic factors. Thirty-day mortality rate was 0% with no intra-procedural deaths.
The long-term OS and PFS following RFA for the treatment of histologically confirmed colorectal lung metastases demonstrate comparable oncological durability to surgery.
评估在组织学证实的结直肠癌肺转移的情况下，使用图像引导射频消融（RFA）治疗的长期结果，主要是总生存（OS）、无进展生存（PFS）和局部肿瘤控制（LTC）。
回顾性单中心研究。2008 年 1 月 1 日至 2014 年 12 月 31 日对组织学证实的肺结直肠转移灶进行了连续的 RFA 治疗。主要结果是患者的生存（OS 和 PFS）。次要结果是局部肿瘤进展（LTP）和并发症。通过单因素和多因素分析确定与 OS/PFS 相关的预后因素。
共 60 例患者（39 名男性：21 名女性；中位年龄 69 岁）和 125 例结直肠肺转移灶接受了治疗。80%（n=48）的患者也因肺转移灶接受了肺手术。转移灶的平均大小（cm）为 1.4±0.6（范围 0.3-4.0）。RFA 治疗的中位数为 1 次（1-4 次）。在随访期间（中位 45.5 个月），45 名患者死亡（75%）。1、3、5、7、9 年的估计 OS 和 PFS 生存率分别为 96.7%、74.7%、44.1%、27.5%、16.3%（中位 OS，52 个月）和 66.7%、31.2%、25.9%、21.2%和 5.9%（中位 PFS，19 个月）。LTC 率为 90%，6 例患者出现 LTP，1、2、3 和 4 年的 LTP 率分别为 3.3%、8.3%、10.0%和 10.0%。无进展间隔<1 年（P=0.002，HR=0.375）和治疗的肺转移总数（≥3）（P=0.037，HR=0.480）是独立的负预后因素。30 天死亡率为 0%，无术中死亡。
在组织学证实的结直肠癌肺转移灶中，RFA 治疗的长期 OS 和 PFS 显示出与手术相当的肿瘤学耐久性。
