Clinical efficacy of radiofrequency ablation for the treatment of metastatic hepatic carcinoma / 中华消化外科杂志

ABSTRACT

Objective To investigate the clinical efficacy of radiofrequency ablation for the treatment of metastatic hepatic carcinoma.Methods The clinical data of 87 patients with metastasis hepatic carcinoma who received radiofrequency ablation (RFA) at the Southwest Hospital from January 2004 to December 2008 were retrospectively analyzed.Of the 87 patients,34 were with liver metastasis from colonic cancer,33 with liver metastasis from rectal cancer,12 with liver metastasis from pancreatic cancer,and 8 with liver metastasis from gastric cancer.The survival of the patients was analyzed by life score and kamofsky performance status (KPS)scale.Patients were followed up via phone call and out-patient examination.Ultrasonography,computed tomography,liver function and tumor markers test were done every month within postoperative 6 months,and every 2 months at 6 months later.The follow-up was ended in Novermber 2013.All data were analyzed using chi-square test or rank sum test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was compared using the Log-rank test.Results Of the 87 patients,84 were successfully treated by RFA,and 3 patients gave up RFA because of unbearable pain (2 patients with colonic cancer and 1 with gastric cancer).A total of 129 metastatic lesions were detected in the 84 patients,and 107 metastatic lesions were ablated after single RFA,with the success rate of 82.95％ (107/129).The other 22 lesions were ablated after a second RFA.The mean duration of hospital stay was (10.7 ± 2.3) days (range,4-29 days).Before operation,the life quality was excellent in 60.7％ (51/84) of patients,good in 22.6％ (19/84) of patients,fair in 10.7％ (9/84) of patients,and poor in 6.0％ (5/84) of patients.The candition of 63.1％ (53/84) of patients was improved,29.8％ (25/84) of patients was stable,and 7.1％ (6/84) of patients was deteriorated.At postoperative month 6,the life quality was excellent in 78.2％ (54/69) of patients,good in 11.6％ (8/69) of patients,fair in 5.8％ (4/69) of patients,and poor in 4.4％ (3/69) of patients.The condition of 73.9％ (51/69) of patients was improved,21.7％ (15/69) of patients was stable,and 4.4％ (3/69) of patients was deteriorated.There were significant differences in the life score and KPS scale between patients before and after operation (x2 =29.760,17.140,P ＜ 0.05).All patients were followed up for 6-60 months.The 1-,3-,5-year survival rates of patients with liver metastasis from colonic cancer after RFA treatment were 68.8％,21.9％ and 6.3％,and the median survival time was 21.5 months.The 1,3,5-year survival rates of patients with liver metastasis from rectal cancer after RFA were 66.7％,27.3％,12.1％,and the median survival time was 19.5 months.The 1-,3-,5-year survival rates of patients with liver metastasis from pancreatic cancer after RFA treatment were 41.7％,0 and 0,and the median survival time was 8.5 months.The 1-,3-,5-year survival rates of patients with liver metastasis from gastric cancer after RFA treatment were 71.4％,14.3％ and 0,and the median survival time was 16.5 months.The survival rates of patients with liver metastasis from pancreatic cancer and gastric cancer were significantly lower than those with liver metastasis from colorectal cancer after RFA (x2 =9.169,P ＜ 0.05).Conclusion The efficacy of RFA for selected patients with liver metastasis from digestive tract tumors is satisfactory.