Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Second Department of General Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, 266011, Shandong, China.
Med Oncol. 2023 Jun 22;40(7):209. doi: 10.1007/s12032-023-02065-y.
To evaluate the safety, feasibility, and survival benefit of radiofrequency ablation in liver-only recurrence pancreatic cancer patients after radical pancreatectomy. The data and follow-up of pancreatic cancer patients who suffered liver-only recurrence after radical pancreatectomy from 2015 to 2021 were retrospectively collected. Finally, 19 liver metastases radiofrequency ablation patients were assigned to radiofrequency ablation group, and 41 patients were to systemic treatment group. (1) the baseline, perioperative characteristics, and pathological outcomes were well-balanced. (2) Recurrence pattern showed there were more multiple (> 3) recurrence tumors in systemic treatment patients (multiple one vs. 19, P = 0.005). (3) Median radiofrequency ablation operation time was 30.0 min, median blood loss was 1.0 ml, 4 (21.05%) patients suffered postoperative complications, and 94.74% liver metastases tumors got complete necrosis. The first efficacy evaluation showed a significantly better effect of radiofrequency ablation, complete and partial response rate 72.22% vs. 27.78%, P < 0.001. Overall survival from the initial surgery and after liver recurrence was significantly longer in the radiofrequency ablation group (43.0 vs. 22.0 months, 29.0 vs. 14.0 months, P = 0.003, 0.006, respectively). Progression-free survival after treatment was longer in the radiofrequency ablation group (6.0 vs. 5.0 months, P = 0.029). For liver recurrence tumor ≤ 3, overall survival from the initial surgery and after liver recurrence was significantly longer in radiofrequency ablation patients (43.0 vs. 22.0 months, 29.0 vs. 14.0 months, P = 0.011, 0.013, respectively). Progression-free survival after treatment was longer in the radiofrequency ablation group (7.0 vs. 4.0 months, P = 0.042). Radiofrequency ablation could get a curative purpose for patients with liver-only recurrence after pancreatectomy, improve progression-free survival and overall survival, and with minor surgery damage and risk.
评估射频消融治疗根治性胰切除术后肝内复发胰腺癌患者的安全性、可行性和生存获益。回顾性收集了 2015 年至 2021 年根治性胰切除术后发生肝内复发的胰腺癌患者的数据和随访资料。最终，19 例肝转移射频消融患者被分配至射频消融组，41 例患者为系统治疗组。（1）基线、围手术期特征和病理结果均衡良好。（2）复发模式显示系统治疗组有更多的多发（>3 个）复发性肿瘤（多发 1 例与 19 例，P=0.005）。（3）中位射频消融手术时间为 30.0 分钟，中位出血量为 1.0 毫升，4 例（21.05%）患者发生术后并发症，94.74%的肝转移瘤完全坏死。首次疗效评估显示射频消融效果明显更好，完全缓解和部分缓解率分别为 72.22%和 27.78%，P<0.001。从初始手术到肝复发后的总生存时间在射频消融组明显更长（43.0 个月与 22.0 个月，29.0 个月与 14.0 个月，P=0.003，0.006）。治疗后无进展生存时间在射频消融组更长（6.0 个月与 5.0 个月，P=0.029）。对于肝内复发肿瘤≤3 个的患者，从初始手术到肝复发后的总生存时间在射频消融患者中明显更长（43.0 个月与 22.0 个月，29.0 个月与 14.0 个月，P=0.011，0.013）。治疗后无进展生存时间在射频消融组更长（7.0 个月与 4.0 个月，P=0.042）。射频消融治疗可达到根治性胰切除术后肝内复发患者的治疗目的，提高无进展生存时间和总生存时间，且手术损伤和风险较小。
