Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
Interventional Oncology/IR Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Medicina (Kaunas). 2024 Sep 20;60(9):1536. doi: 10.3390/medicina60091536.
Colorectal cancer is a major cause of cancer-related mortality, with liver metastases occurring in over a third of patients, and is correlated with poor prognosis. Despite surgical resection being the primary treatment option, only about 20% of patients qualify for surgery. Current guidelines recommend thermal ablation either alone or combined with surgery to treat limited hepatic metastases, provided that all visible disease can be effectively eradicated. Several ablation modalities, including radiofrequency ablation, microwave ablation, cryoablation, irreversible electroporation and histotripsy, are part of the percutaneous ablation armamentarium. Thermal ablation, including radiofrequency, microwave ablation and cryoablation, can offer local tumor control rates comparable to limited resection for selected tumors that can be ablated with margins. This review aims to encapsulate the current clinical evidence regarding the efficacy and oncologic outcomes after percutaneous ablation for the treatment of colorectal liver metastatic disease.
结直肠癌是癌症相关死亡的主要原因,超过三分之一的患者发生肝转移,且与预后不良相关。尽管手术切除是主要的治疗选择,但只有约 20%的患者符合手术条件。目前的指南建议单独或联合手术治疗局限性肝转移,前提是所有可见的疾病都能被有效清除。包括射频消融、微波消融、冷冻消融、不可逆电穿孔和组织粉碎术在内的几种消融方式是经皮消融手段的一部分。热消融,包括射频、微波消融和冷冻消融,可以为那些可以用边缘消融的选定肿瘤提供与有限切除相当的局部肿瘤控制率。本综述旨在总结经皮消融治疗结直肠癌肝转移疾病的疗效和肿瘤学结局的现有临床证据。