Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: Long-term results in 117 patients

被引:674
作者
Solbiati, L
Livraghi, T
Goldberg, SN
Ierace, T
Meloni, F
Dellanoce, M
Cova, L
Halpern, EF
Gazelle, GS
机构
[1] Massachusetts Gen Hosp, Dept Radiol, Decis Anal & Technol Assessment Grp, Boston, MA 02114 USA
[2] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA
[3] Osped Gen, Dept Radiol, Busto Arsizio, Italy
[4] Osped Civile, Dept Radiol, Vimercate, Italy
[5] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA
关键词
liver neoplasms; secondary; therapy; radiofrequency (RF) ablation;
D O I
10.1148/radiol.2211001624
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To describe the results of an ongoing radio-frequency (RF) ablation study in patients with hepatic metastases from colorectal carcinoma. MATERIALS AND METHODS: In 117 patients, 179 metachronous colorectal carcinoma hepatic metastases (0.9-9.6 cm in diameter) were treated with RF ablation by using 17-gauge internally cooled electrodes. Computed, tomographic follow-up was performed every 4-6 months. Recurrent tumors were retreated when feasible. Time to new metastases and death for each patient and time to local recurrence for individual lesions were modeled with Kaplan-Meier analysis. Modeling determined the effect of number of metastases on the time to new metastases and death and effect of tumor size on local recurrence. RESULTS: Estimated median survival was 36 months (95% Cl; 28, 52 months). Estimated 1, 2, and 3-year survival rates were 93%, 69%, and 46%, respectively. Survival was not significantly related to number of metastases treated. In 77 (66%) of 117 patients, new metastases were observed at follow-up. Estimated median time until new metastases was 12 months (95% Cl; 10, 18 months). Percentages of patients with no new metastases after initial treatment at 1 and 2 years were 49% and 35%, respectively. Time to new metastases was not significantly related to number of metastases. Seventy (39%) of 179 lesions developed local recurrence after treatment. Of these, 54 were observed by 6 months and 67 by 1 year. No local recurrence was observed after 18 months. Frequency and time to local recurrence were related to lesion size (P less than or equal to .001). CONCLUSION: RF ablation is an effective method to treat hepatic metastases from colorectal carcinoma.
引用
收藏
页码:159 / 166
页数:8
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