Cheng Hou-Ying, Huang Kai-Wen, Liang Jin-Tung, Lin Been-Ren, Huang John, Hung Ji-Shiang, Chen Chi-Ling
Division of General Surgery, Department of Surgery, National Taiwan University Hospital, Taipei 100229, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
J Clin Med. 2021 Aug 20;10(16):3712. doi: 10.3390/jcm10163712.
The outcome of radiofrequency ablation (RFA) for liver metastases from colorectal cancer (CRLM) has been thought to be inferior to metastasectomy. However, the recent development of multielectrode RFA (multi-RFA) systems has made the ablation zone larger and more complete. Thus, we assessed the survival benefits of this modality in cases of metachronous CRLM. This retrospective study assessed patients diagnosed with resectable metachronous CRLM between 2013 and 2016; 132 patients were categorized by treatment for liver metastases: multi-RFA ( = 68), hepatectomy ( = 34), or systemic treatment only ( = 30). Therapeutic effectiveness, outcomes, and intervention-related complications were compared between groups. Median overall survival (OS), recurrence-free survival (RFS), and intrahepatic recurrence-free survival (IHRFS) were 69.8, 85.2, and 59.7 months for the hepatectomy group; 53.4, 41.3, and 32.3 months for the multi-RFA group; and 19.1, 7.1, and 7.1 months for the systemic treatment group. No significant differences were observed between the multi-RFA and hepatectomy groups after a median follow-up of 59.8 months. This study demonstrated that multi-RFA and hepatectomy provide similar survival benefits for patients with resectable CRLM. Multi-RFA may represent a reliable treatment option for the management of resectable liver metastases.
一直以来，人们认为射频消融术（RFA）治疗结直肠癌肝转移（CRLM）的效果不如肝转移瘤切除术。然而，多电极RFA（多针RFA）系统的最新发展使消融区域更大且更完整。因此，我们评估了这种治疗方式在异时性CRLM病例中的生存获益。这项回顾性研究评估了2013年至2016年间被诊断为可切除异时性CRLM的患者；132例患者根据肝转移的治疗方法进行分类：多针RFA（n = 68）、肝切除术（n = 34）或仅进行全身治疗（n = 30）。比较了各组之间的治疗效果、结局和干预相关并发症。肝切除组的中位总生存期（OS）、无复发生存期（RFS）和肝内无复发生存期（IHRFS）分别为69.8个月、85.2个月和59.7个月；多针RFA组分别为53.4个月、41.3个月和32.3个月；全身治疗组分别为19.1个月、7.1个月和7.1个月。中位随访59.8个月后，多针RFA组和肝切除组之间未观察到显著差异。这项研究表明，多针RFA和肝切除术为可切除CRLM患者提供了相似的生存获益。多针RFA可能是治疗可切除肝转移瘤的一种可靠选择。
