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不同肿瘤实体肝转移灶的磁共振引导下射频消融术后10年单中心生存分析。

Single-centre survival analysis over 10 years after MR-guided radiofrequency ablation of liver metastases from different tumour entities.

作者信息

Olthof Susann-Cathrin, Wessling Daniel, Winkelmann Moritz T, Rempp Hansjörg, Nikolaou Konstantin, Hoffmann Rüdiger, Clasen Stephan

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Radiologie Waiblingen, Alter Postplatz 2, 71332, Waiblingen, Germany.

出版信息

Insights Imaging. 2022 Mar 21;13(1):48. doi: 10.1186/s13244-022-01178-8.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) is a minimal-invasive, local therapy in patients with circumscribed metastatic disease. Although widely used, long time survival analysis of treated liver metastases is still pending while also analysing the patients' experience of MR-based radiofrequency.

METHODS

Monocentric, retrospective analysis of long-time overall and progression free survival (OS; PFS) of 109 patients, treated with MRI-guided hepatic RFA between 1997 and 2010, focusing on colorectal cancer patients (CRC). Complimentary therapies were evaluated and Kaplan Meier-curves were calculated. Patients' experience of RFA was retrospectively assessed in 28 patients.

RESULTS

1-, 3-, 5-, 10-year OS rates of 109 patients with different tumour entities were 83.4%, 53.4%, 31.0% and 22.9%, median 39.2 months, with decreasing survival rates for larger metastases size. For 72 CRC patients 1-, 3-, 5-, 10-year OS rates of 90.2%, 57.1%, 36.1% and 26.5% were documented (median 39.5 months). Thereof, beneficial outcome was detected for patients with prior surgery of the CRC including chemotherapy (median 53.0 months), and for liver metastases up to 19 mm (28.5% after 145 months). Hepatic PFS was significantly higher in patients with liver lesions up to 29 mm compared to larger ones (p = 0.035). 15/28 patients remembered RFA less incriminatory than other applied therapies.

CONCLUSIONS

This is the first single-centre, long-time OS and PFS analysis of MRI-guided hepatic RFA of liver metastases from different tumour entities, serving as basis for further comparison studies. Patients' experience of MR based RFA should be analysed simultaneously to the performed RFA in the future.

摘要

背景

射频消融(RFA)是一种针对局限性转移性疾病患者的微创局部治疗方法。尽管已被广泛应用,但对于接受治疗的肝转移患者的长期生存分析仍有待进行,同时还需分析患者对基于磁共振成像(MR)的射频治疗的体验。

方法

对1997年至2010年间接受磁共振成像引导下肝脏射频消融治疗的109例患者进行单中心回顾性分析,重点关注结直肠癌患者(CRC)。评估辅助治疗情况并计算Kaplan-Meier曲线。对28例患者回顾性评估其对射频消融治疗的体验。

结果

109例不同肿瘤类型患者的1年、3年、5年、10年总生存率分别为83.4%、53.4%、31.0%和22.9%,中位生存期为39.2个月,转移灶越大生存率越低。72例结直肠癌患者的1年、3年、5年、10年总生存率分别为90.2%、57.1%、36.1%和26.5%(中位生存期39.5个月)。其中,先前接受过包括化疗在内的结直肠癌手术的患者以及肝转移灶直径达19毫米的患者预后良好(145个月后为28.5%)。与较大肝转移灶患者相比,肝转移灶直径达29毫米的患者肝无进展生存期显著更长(p = 0.035)。28例患者中有15例认为射频消融治疗相比其他治疗手段带来的不良影响更小。

结论

这是首次对不同肿瘤类型肝转移灶进行磁共振成像引导下肝脏射频消融治疗的单中心长期总生存和无进展生存分析,为进一步的比较研究奠定了基础。未来在进行射频消融治疗的同时应同步分析患者对基于磁共振成像的射频消融治疗的体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d123/8938560/bb422e90d60c/13244_2022_1178_Fig1_HTML.jpg

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