肝切除术后复发性结直肠肝转移的立体定向射频消融（SRFA）。
Stereotactic radiofrequency ablation (SRFA) for recurrent colorectal liver metastases after hepatic resection.
机构信息
Department of Radiology, Section of Interventional Oncology - Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Royal Marsden Hospital, 203 Fulham Road, Chelsea, London, SW3 6JJ, UK.
出版信息
Eur J Surg Oncol. 2021 Apr;47(4):866-873. doi: 10.1016/j.ejso.2020.09.034. Epub 2020 Oct 1.
BACKGROUND
To evaluate the efficacy, safety and overall clinical outcome of multiprobe SRFA as a treatment for recurrent colorectal liver metastases after hepatic resection (HR).
METHODS
A retrospective, single center study carried out between 2006 and 2018. 64 consecutive patients with recurrent or new CRLM after previous HR were treated by SRFA for 217 lesions (median size 2.7 cm, 1-7.5) in 103 ablation sessions. Endpoints consisted of i) technical efficacy ii) complication and mortality rates iii) local and distant recurrence, iv) disease free survival (DFS), and v) overall survival (OS).
RESULTS
213/217 tumors were successfully ablated at initial SRFA (97.7% primary technical efficacy rate). Four tumors required repeat ablation, resulting in a secondary technical efficacy rate of 99.5% (216/217). Local recurrence developed in 25/217 lesions (11.5%). Major complication rate was 5.8% (6/103 sessions) and mortality rate was 1.0% (1/103 ablation sessions), respectively.1-, 3-, and 5- year OS rates from date of first SRFA were 90.1%, 46.2%, and 34.8% (median 33.1 months). DFS rates were 54.2%, 17.2%, and 17.2%, at 1-, 3- and 5- years, respectively (median 13.3 months).
CONCLUSION
SRFA is a safe, feasible and effective option for CRLM after HR with low morbidity levels and favorable clinical outcome.
背景
评估多探针 SRFA 作为治疗肝切除（HR）后复发性结直肠肝转移（CRLM）的疗效、安全性和总体临床结果。
方法
这是一项 2006 年至 2018 年间进行的回顾性、单中心研究。64 例先前 HR 后复发或新发 CRLM 的患者接受了 SRFA 治疗，共 103 次消融治疗 217 个病灶（中位大小 2.7cm，1-7.5cm）。终点包括 i）技术疗效 ii）并发症和死亡率 iii）局部和远处复发，iv）无病生存率（DFS）和 v）总生存率（OS）。
结果
217 个肿瘤中的 213 个在初始 SRFA 时成功消融（初级技术疗效率 97.7%）。4 个肿瘤需要重复消融，导致二级技术疗效率为 99.5%（216/217）。217 个病灶中有 25 个发生局部复发（11.5%）。主要并发症发生率为 5.8%（103 次消融治疗中 6 次），死亡率为 1.0%（103 次消融治疗中 1 次）。首次 SRFA 后 1、3 和 5 年的 OS 率分别为 90.1%、46.2%和 34.8%（中位 33.1 个月）。DFS 率分别为 54.2%、17.2%和 17.2%，分别为 1、3 和 5 年（中位 13.3 个月）。
结论
SRFA 是 HR 后 CRLM 的一种安全、可行且有效的选择，具有较低的发病率和良好的临床结果。
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