RESUMO
Intestinal malformations are common defects of the newborn, treated in experienced centres. Reports on long-term follow-up and associated complications are scarce, possibly leading to misinterpretation of clinical signs and symptoms in adulthood. To prevent treatment errors, it is important that physicians are aware of long-term complications of intestinal malformations.
Assuntos
Anastomose Cirúrgica , Obstrução Duodenal/complicações , Duodeno/anormalidades , Doenças Fetais/etiologia , Complicações Pós-Operatórias/cirurgia , Bexiga Urinária/anormalidades , Cuidados Críticos , Obstrução Duodenal/diagnóstico , Obstrução Duodenal/fisiopatologia , Obstrução Duodenal/cirurgia , Duodeno/fisiopatologia , Duodeno/cirurgia , Dispneia/etiologia , Doenças Fetais/diagnóstico , Doenças Fetais/fisiopatologia , Doenças Fetais/cirurgia , Gastroscopia , Humanos , Recém-Nascido , Atresia Intestinal , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/fisiopatologia , Fatores de Tempo , Bexiga Urinária/fisiopatologia , Bexiga Urinária/cirurgia , Redução de PesoRESUMO
PURPOSE: To evaluate the local tumor control rate and survival data for magnetic resonance (MR) imaging-guided laser ablation of breast cancer liver metastases by using laser-induced interstitial thermotherapy (LITT). MATERIALS AND METHODS: MR-guided LITT was performed in 232 female patients with 578 liver metastases from breast cancer. Survival rates were calculated with the Kaplan-Meier method. Indications for the procedure were defined for patients with no more than five metastases, none of which were larger than 5 cm in diameter, as follows: recurrent liver metastases after partial liver resection (8.2%), metastases in both liver lobes (45.2%), locally nonresectable tumors (19%), general contraindications for surgery (2.6%), or refusal to undergo surgical resection (25%). RESULTS: Local recurrence rate at 6-month follow-up after LITT was 2.3% (five of 213) for metastases up to 2 cm in diameter, 4.3% (seven of 162) for metastases 2-3 cm in diameter, 3.2% (two of 63) for metastases 3-4 cm in diameter, and 1.9% (one of 52) for metastases larger than 4 cm in diameter. No additional local tumor progression was observed beyond 6 months. The mean survival rate for all treated patients, with calculation started on the date of diagnosis of the metastases treated with LITT, was 4.9 years (95% confidence interval: 4.3, 5.4). The median survival was 4.3 years; 1-year survival, 96%; 2-year survival, 80%; 3-year survival, 63%; and 5-year survival, 41%. The mean survival after the first LITT treatment was 4.2 years (95% confidence interval: 3.6, 4.8). CONCLUSION: MR-guided LITT yields high local tumor control and survival rates in patients with liver metastases from breast cancer.
Assuntos
Neoplasias da Mama/patologia , Hipertermia Induzida/métodos , Terapia a Laser , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Imageamento por Ressonância Magnética , Adulto , Idoso , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Taxa de Sobrevida , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the local tumor control and survival data for magnetic resonance (MR) imaging-guided laser-induced interstitial thermotherapy (LITT) of colorectal liver metastases. MATERIALS AND METHODS: MR imaging-guided LITT was performed in 603 patients (mean age, 61.2 years) with 1,801 liver metastases of colorectal cancer. Survival rates were calculated by means of the Kaplan-Meier method. Local tumor control and tumor volume were evaluated with nonenhanced and contrast material-enhanced MR imaging. Indications for the procedure were defined for patients with five or fewer metastases, none of which were larger than 5 cm in diameter. The indications included recurrent liver metastases after partial liver resection in 37.6% of study patients, metastases in both liver lobes in 32.5%, locally nonresectable lesions in 11.3%, general contraindications for surgery in 4.6%, and refusal to undergo surgical resection in 13.9%. RESULTS: Local recurrence rate at 6-month follow-up was 1.9% (nine of 474) for metastases up to 2 cm in diameter, 2.4% (13 of 539) for metastases 2.1-3.0 cm in diameter, 1.2% (four of 327) for metastases 3.1-4.0 cm in diameter, and 4.4% (13 of 294) for metastases larger than 4 cm in diameter. The mean survival rate for all treated patients, with calculation started on the date of diagnosis of the metastases (which were treated with LITT) was 4.4 years (95% CI: 4.0, 4.8) (1-year survival, 94%; 2-year survival, 77%; 3-year survival, 56%; 5-year survival, 37%). Median survival was 3.5 years (95% CI: 3.0, 3.9). Mean survival after the first LITT treatment was 3.8 years (95% CI: 3.4, 4.2). Median survival was 2.9 years (95% CI: 2.4, 3.3). CONCLUSION: MR imaging-guided LITT yields high local tumor control and survival rates in well-selected patients with limited liver metastases of colorectal carcinoma.