手术切除、射频消融及海扶刀治疗结直肠癌肝转移患者的不同预后比较  

Comparison of prognosis among patients with colorectal cancer liver metastases treated by surgical resection,radiofrequency ablation and HIFU

作　　者：徐缨龙 胡建容 李世红[1] 于澜[1] 李云涛[1] XU Ying-long;HU Jian-rong;LI Shi-hong;YU Lan;LI Yun-tao(Department of General Surgery,The Affiliated Hospital,Southwest Jiaotong University,Chengdu Third People’s Hospital,Chengdu 610031,China;Surgical Anesthesia center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]成都市第三人民医院普外科,四川成都610031 [2]四川大学华西医院手术室,四川成都610041

出　　处：《实用医院临床杂志》2020年第1期103-106,共4页Practical Journal of Clinical Medicine

摘　　要：目的比较肝切除术(HR),射频消融(RFA)和海扶刀(HIFU)治疗结直肠癌肝转移(CRLM)的不同预后。方法我院经HR、RFA及HIFU治疗的CRLM患者71例,提取患者临床一般资料、诊断、治疗、病理结果、随访无复发生存率(RFS)和总生存率(OS)进行分析。结果 41例HR,20例RFA,10例HIFU进行了有效随访。HR和RFA组及HR和HIFU组的复发模式差异有统计学意义(P <0. 05)。HR组与HIFU组OS、RFS差异有统计学意义(P <0. 05),HR组与RFA组OS、RFS差异无统计学意义(P> 0. 05)。多因素分析显示转移灶的治疗和肝转移灶数目是预后的独立预测因子。结论 RFA治疗结直肠癌肝转移的疗效与HR相似,HIFU治疗结直肠癌肝转移的疗效低于HR治疗结直肠癌肝转移的疗效。Objective To compare the prognosis of patients undergoing hepatic resection(HR),radiofrequency ablation(RFA)or high-intensity focused ultrasound ablation(HIFU)for colorectal cancer liver metastases(CRLM).Methods A retrospective analysis was performed on 71 patients with CRLM treated by HR or RFA or HIFU in our hospital. Patients’ demographics, diagnosis, treatment, pathological results, follow-up, recurrence-free survival (RFS) and overall survival (OS) were extracted and analyzed. Results Of the 71 patients, 41 patients were treated with HR, 20 patients with RFA and 10 patients with HIFU and they were followed up. The recurrence patterns were significantly different between the HR and the RFA group and between the HR and the HIFU group (P< 0.05). The OS and RFS were significantly different between the HR group and the HIFU group (P < 0.05) while no significant difference was found between the HR group and RFA group (P > 0.05). Multivariate analysis showed that metastases treatment and number of liver metastases were significantly prognostic factors. Conclusion RFA has similar outcomes to HR while HIFU had poorer outcomes than HR for RFS and OS in treating colorectal liver metastases.

关 键 词：结直肠癌肝转移 肝切除术 射频消融 海扶刀 生存率 

分 类 号：R735.3[医药卫生—肿瘤]