Recurrence after microwave ablation of liver malignancies: a single institution experience

被引:38
作者
Groeschl, Ryan T. [1 ]
Wong, Ray K. [1 ]
Quebbeman, Edward J. [1 ]
Tsai, Susan [1 ]
Turaga, Kiran K. [1 ]
Pappas, Sam G. [1 ]
Christians, Kathleen K. [1 ]
Hohenwalter, Eric J. [2 ]
Tutton, Sean M. [2 ]
Rilling, William S. [2 ]
Gamblin, T. Clark [1 ]
机构
[1] Med Coll Wisconsin, Dept Surg, Div Surg Oncol, Milwaukee, WI 53226 USA
[2] Med Coll Wisconsin, Dept Radiol, Sect Vasc & Intervent Radiol, Milwaukee, WI 53226 USA
关键词
HEPATOCELLULAR-CARCINOMA PRIOR; COAGULATION THERAPY; METASTASIS; MANAGEMENT; EFFICACY; SAFETY; TUMORS;
D O I
10.1111/j.1477-2574.2012.00585.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Microwave ablation (MWA) is increasingly used to achieve local control for liver tumours. This study sought to examine a monocentric experience with MWA, with a primary hypothesis that primary tumour histology was a significant predictor of early recurrence. Methods Retrospective single-institution review identified consecutive patients with liver tumours treated by MWA. Cox proportional hazards models assessed significance of prognostic variables. Results Seventy-two patients (43 female, 60%) underwent 83 MWA procedures for 157 tumours. Tumour histologies included hepatocellular cancer (10 operations), colorectal metastases (39), metastatic carcinoid (20) and other (14). The median tumour size was 2.0cm. A concomitant liver resection was performed in 50 cases (60%). Crude peri-operative morbidity and mortality rates were 16% and 1%, respectively. The median follow-up was 16 months. Ablations were complete for 149 out of 157 tumours (95%). The median overall and recurrence-free survivals were 36 and 18 months, respectively. There was no difference in time to recurrence between the primary tumour types. In multivariable models, recurrence-free survival was independently associated with the use of neoadjuvant [hazard ratio (HR): 2.90, 95% confidence interval (CI): 1.097.76, P = 0.034] and adjuvant chemotherapy (HR: 0.36, 95% CI: 0.150.82, P = 0.016). Conclusions MWA is a safe and feasible approach for local control of liver tumours. While chemotherapy administration was associated with time to recurrence after MWA, larger studies are needed to corroborate these findings.
引用
收藏
页码:365 / 371
页数:7
相关论文
共 28 条
[1]   Solitary colorectal liver metastasis - Resection determines outcome [J].
Aloia, TA ;
Vauthey, JN ;
Loyer, EM ;
Ribero, D ;
Pawlik, TM ;
Wei, SH ;
Curley, SA ;
Zorzi, D ;
Abdalla, EK .
ARCHIVES OF SURGERY, 2006, 141 (05) :460-466
[2]   Radiotherapy for unresectable hepatic malignancies [J].
Ben-Josef, E ;
Lawrence, TS .
SEMINARS IN RADIATION ONCOLOGY, 2005, 15 (04) :273-278
[3]   Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review [J].
Bertot, Luis Calzadilla ;
Sato, Masaya ;
Tateishi, Ryosuke ;
Yoshida, Haruhiko ;
Koike, Kazuhiko .
EUROPEAN RADIOLOGY, 2011, 21 (12) :2584-2596
[4]   Isolated Hepatic Perfusion for the Treatment of Liver Metastases [J].
Boone, Brian A. ;
Bartlett, David L. ;
Zureikat, Amer H. .
CURRENT PROBLEMS IN CANCER, 2012, 36 (02) :27-76
[5]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[6]   Regional infusion-radioembolization [J].
Dubel, Gregory J. ;
Soares, Gregory M. .
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA, 2008, 17 (04) :957-+
[7]   Radiofrequency Ablation of Neuroendocrine Hepatic Metastasis [J].
Gamblin, T. Clark ;
Christians, Kathleen ;
Pappas, Sam G. .
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA, 2011, 20 (02) :273-+
[8]   Downstaging hepatocellular carcinoma prior to liver transplantation [J].
Gamblin, TC ;
Geller, DA .
LIVER TRANSPLANTATION, 2005, 11 (12) :1466-1468
[9]   Hepatectomy for Noncolorectal Non-Neuroendocrine Metastatic Cancer: A Multi-Institutional Analysis [J].
Groeschl, Ryan T. ;
Nachmany, Ido ;
Steel, Jennifer L. ;
Reddy, Srinevas K. ;
Glazer, Evan S. ;
de Jong, Mechteld C. ;
Pawlik, Timothy M. ;
Geller, David A. ;
Tsung, Allan ;
Marsh, J. Wallis ;
Clary, Bryan M. ;
Curley, Steven A. ;
Gamblin, T. Clark .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2012, 214 (05) :769-777
[10]   Bridging Locoregional Therapy for Hepatocellular Carcinoma Prior to Liver Transplantation [J].
Heckman, Jason T. ;
deVera, Michael B. ;
Marsh, J. Wallis ;
Fontes, Paulo ;
Amesur, Nikhil B. ;
Holloway, Shane E. ;
Nalesnik, Michael ;
Geller, David A. ;
Steel, Jennifer L. ;
Gamblin, T. Clark .
ANNALS OF SURGICAL ONCOLOGY, 2008, 15 (11) :3169-3177