University of Minnesota Department of Surgery, Division of Surgical Oncology, Minneapolis, MN, USA.
University of Minnesota Department of Surgery, Division of Surgical Oncology, Minneapolis, MN, USA.
Surg Oncol. 2021 Mar;36:61-64. doi: 10.1016/j.suronc.2020.11.016. Epub 2020 Nov 30.
Colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancers, however, only 15-20% of these patients are candidates for resection. We reviewed our institutional experience with 135 surgical ablations for unresectable CRLM.
Retrospective review of surgically ablated CRLM from 2009 to 2018. Patient-specific variables were obtained from the medical record. Kaplan-Meier modeling was performed for survival analyses.
We ablated 135 CRLM in 36 patients over 40 procedures. Median age was 52 years and 58% of patients were male. All patients received systemic chemotherapy. The ablation procedure was completed laparoscopically in 68% of procedures. Median number of ablated lesions per patient was 2 (range 1-15). Median maximum diameter of ablated lesions was 1.9 cm (range 0.5-12.2). Median follow up of the study was 28 months. In this time, median disease-free survival was not reached. Of the 135 lesions ablated, the per-lesion recurrence rate was 6/135 (4.4%). Median overall survival was 81 months.
Surgical ablation of CRLM can provide excellent local control and long-term survival outcomes in patients who may otherwise not be candidates for other liver-directed therapies.
结直肠癌肝转移（CRLM）是结直肠癌最常见的淋巴外转移，但只有 15-20%的患者适合进行切除术。我们回顾了我们机构对 135 例不可切除 CRLM 的手术消融经验。
回顾性分析 2009 年至 2018 年接受手术消融的 CRLM。从病历中获取患者特定变量。采用 Kaplan-Meier 模型进行生存分析。
我们在 40 多次手术中消融了 36 例 CRLM。中位年龄为 52 岁，58%的患者为男性。所有患者均接受了系统化疗。68%的手术采用腹腔镜完成消融。每位患者的消融病灶中位数为 2 个（范围 1-15）。消融病灶的最大直径中位数为 1.9 厘米（范围 0.5-12.2）。研究的中位随访时间为 28 个月。在此期间，无疾病进展中位生存时间尚未达到。在消融的 135 个病灶中，135 个病灶中有 6 个（4.4%）出现病灶局部复发。中位总生存时间为 81 个月。
在其他肝导向治疗可能不适合的患者中，CRLM 的手术消融可以提供极好的局部控制和长期生存结果。
