手术联合术中射频消融对结直肠癌合并肝脏转移的疗效  

Efficacy of radiofrequency ablation-assisted hepatectomy in treating colorectal liver metastases

作　　者：周泉宇[1] 雷泽华[1] 蒋康怡 ZHOU Quanyu;LEI Zehua;JIANG Kangyi(Department of Hepatobiliary Surgery,Leshan People's Hospital,Leshan 614000,CHINA)

机构地区：[1]乐山市人民医院肝胆外科

出　　处：《江苏医药》2019年第12期1217-1220,共4页Jiangsu Medical Journal

摘　　要：目的观察手术联合术中射频消融(RFA)对结直肠癌合并肝脏转移(CLM)患者的疗效。方法病理活检确诊CLM患者174例,结直肠癌原发灶已经根治性切除。其中,24例(A组)无法完全手术切除肝脏转移灶,术中同时实施RFA治疗,B组150例,肝转移灶可完全手术切除。随访两组患者肿瘤复发和存活情况。结果A组共切除78个病灶,消融41个病灶;B组共切除191个病灶。A组3年无病生存率高于B组(29.2%vs.13.3%)(P<0.01)。A组肿瘤复发率(100.0%vs.68.7%)和仅肝内复发率(50.0%vs.36.9%)高于B组(P<0.05)。A、B组3年总生存率相仿(66.7%vs.61.3%)(P>0.05)。切除肿瘤数目、辅助化疗、术前肿瘤大小为影响CLM患者总生存时间的独立预后因素(P<0.05)。结论手术联合术中射频消融与单纯行手术治疗CLM患者疗效相近。Objective To observe the efficacy of radiofrequency ablation(RFA)combined with hepatectomy in the treatment of colorectal liver metastases(CLM).Methods CLM was confirmed by pathological biopsy in 174 patients with colorectal cancer after the primary focus had been radically resected.Of 174 cases,24 cases(group A)received hepatectomy and RFA of unresectable metastatic focuses and 150 cases received surgical resection of all resectable metastatic focuses.All the patients were followed up for the recurrence and survival status.Results A total of 78 lesions was resected and 41 lesions were ablated in group A.A total of 191 lesions was resected in group B.The 3-year disease-free survival rate of Group A was higher than that of group B(29.2%vs.13.3%)(P<0.01).The tumor recurrence rate of A group was higher than that of group B(100.0%vs.68.7%).So did the intrahepatic recurrence rate only(50.0%vs.36.9%).The overall 3-year survival rate of group A was similar to that of group B(66.7%vs.61.3%)(P>0.05).The number of resected tumors,adjuvant chemotherapy and preoperative tumor size were independent prognostic factors affecting the total survival time of patients with CLM(P<0.05).Conclusion Combined use of hepatectomy and RFA of unresectable metastatic focuses has similar clinical efficacy of hepatectomy alone in the patients with CLM.

关 键 词：射频消融 结直肠癌 

分 类 号：R459[医药卫生—治疗学]