【摘 要】
：
Objectives: Only 15% of patients with colorectal liver metastases (CLM) are candidates for curative hepatectomy at time of diagnosis, limited by anatomical location and tumor burden.Ablative therapies
【机 构】
：
Hepatobiliary and Surgical Oncology Unit,Department of Surgery,St George Hospital,University of New
论文部分内容阅读
Objectives: Only 15% of patients with colorectal liver metastases (CLM) are candidates for curative hepatectomy at time of diagnosis, limited by anatomical location and tumor burden.Ablative therapies may extend this.This study reports a single institution s long-term experience with hepatic cryotherapy for advanced CLM.Methods: Between April 1990 and June 2009, 304 patients were curatively treated with cryotherapy.Survival was estimated by Kaplan-Meier method.Prognostic factors for survivals were determined by using univariate and multivariate analyses.Results: A total of 293 patients were included into analysis.The median number of lesions treated per patient was three (range, 1-13).The median overall survival was 29 (range, 3-220) months.The 1-, 3-, 5-, and 10-year survivals were 87%, 41.8%, 24.2%, and 13.3%, respectively.A total of 161 patients developed intrahepatic recurrences: cryosite (23%); edge recurrence (14%); and within the liver remnant (78%).The median disease-free survival (DFS) was 9 (range, 1-220) months.The 1-, 3-, 5-, and 10-year DFS rates were 37.9%, 17.2%, 13.4%, and 10.8%, respectively.Univariate analysis identified four factors that significantly affect survival: nodepositive primary tumor (p=0.001), preoperative CEA level (p<0.001), number of lesions (p<0.001),and use of neoadjuvant chemotherapy (p<0.001).However, only primary tumor nodal status was independently prognostic (hazards ratio =2.023; 95% confidence interval, 1.444-2.835; p\0.001).Conclusions: Hepatic cryotherapy seems to be a safe and effective ablative technique for the treatment of colorectal liver metastases and may offer long-term survival in otherwise unresectable disease.
其他文献
Advances have been made in the past few decades in diagnosing cancers including improved imaging systems, endoscopies, and blood tests.However, significant portion of patients with cancer diagnosed at
Over the past decades, thermoablative techniques for the therapy of localized tumors have gained importance in the treatment of patients not eligible for surgical resection.Anecdotal reports have desc
HSF4 mutations lead to both congenital and age-related cataract.The purpose of this study was to explore the mechanism of cataract formation caused by HSF4 mutations.The degradation of nuclear DNA is
Objective Oral leukoplakia (OL) is the most common premalignant lesion in the site of oral cavity.However, only a small proportion of OLs progress to oral squamous cell carcinoma (OSCC).For early iden
Purpose: To evaluate the safety and feasibility of cryoablation for lung tumors as well as the incidence of, and risk factors for, complications.Materials and Methods: This study included 193 cryoabla
Primary lung cancer is the leading cause of cancer death in the United States.Lobectomy is the treatment of choice for early-stage non-small-cell lung cancer.For patients who are not suitable surgical
Purpose: To assess feasibility, complications, local tumor recurrences, overall survival (OS), and estimates of cost effectiveness for multisite cryoablation (MCA) of oligometastatic nonsmall-cell lun
Background: To evaluate the midterm results of percutaneous cryoablation for medically inoperable stage Ⅰ non-small cell lung cancer.Methodology/Principal Findings: Between January 2004 and June 2010,
KEY POINTS · Image-guided ablation is an alternative treatment in stage 1 nonsmall cell lung cancer (NSCLC) in selected nonsurgical patients with comorbidities and recurrent disease after radiation or
Abdominal approach is commonly used for resection of liver tumors.However, in rare cases,transthoracic approach may be a valuable option for management of lesions located in the hepatic dome or involv