文章：

热消融治疗小尺寸（0–3 cm）与中等尺寸（3–5 cm）结直肠癌肝转移的疗效：来自阿姆斯特丹结直肠癌肝转移登记处（AmCORE）的结果

Efficacy of Thermal Ablation for Small-Size (0–3 cm) versus Intermediate-Size (3–5 cm) Colorectal Liver Metastases: Results from the Amsterdam Colorectal Liver Met Registry (AmCORE)

原文发布日期：31 August 2023

DOI: 10.3390/cancers15174346

类型: Article

开放获取: 是

英文摘要：

Purpose: Thermal ablation is widely recognized as the standard of care for small-size unresectable colorectal liver metastases (CRLM). For larger CRLM safety, local control and overall efficacy are not well established and insufficiently validated. The purpose of this comparative series was to analyze outcomes for intermediate-size versus small-size CRLM. Material and methods: Patients treated with thermal ablation between December 2000 and November 2021 for small-size and intermediate-size CRLM were included. The primary endpoints were complication rate and local control (LC). Secondary endpoints included local tumor progression-free survival (LTPFS) and overall survival (OS). Results: In total, 59 patients were included in the intermediate-size (3–5 cm) group and 221 in the small-size (0–3 cm) group. Complications were not significantly different between the two groups (p= 0.546). No significant difference between the groups was found in an overall comparison of OS (HR 1.339; 95% CI 0.824–2.176;p= 0.239). LTPFS (HR 3.388;p< 0.001) and LC (HR 3.744;p= 0.004) were superior in the small-size group. Nevertheless, the 1-, 3-, and 5-year LC for intermediate-size CRLM was still 93.9%, 85.4%, and 81.5%, and technical efficacy improved over time. Conclusions: Thermal ablation for intermediate-size unresectable CRLM is safe and induces long-term LC in the vast majority. The results of the COLLISION-XL trial (unresectable colorectal liver metastases: stereotactic body radiotherapy versus microwave ablation—a phase II randomized controlled trial for CRLM 3–5 cm) are required to provide further clarification of the role of local ablative methods for intermediate-size unresectable CRLM.

摘要翻译： 

目的：热消融被广泛认为是治疗小尺寸不可切除结直肠肝转移瘤（CRLM）的标准方案。对于较大尺寸的CRLM，其安全性、局部控制效果及总体疗效尚未明确确立且缺乏充分验证。本比较性系列研究的目的是分析中等尺寸与小尺寸CRLM的治疗结果。 材料与方法：研究纳入了2000年12月至2021年11月期间因小尺寸及中等尺寸CRLM接受热消融治疗的患者。主要终点为并发症发生率和局部控制率（LC）。次要终点包括局部肿瘤无进展生存期（LTPFS）和总生存期（OS）。 结果：中等尺寸组（3–5 cm）共纳入59例患者，小尺寸组（0–3 cm）纳入221例患者。两组间并发症发生率无显著差异（p=0.546）。在OS的总体比较中，两组间亦未发现显著差异（HR 1.339；95% CI 0.824–2.176；p=0.239）。小尺寸组的LTPFS（HR 3.388；p<0.001）和LC（HR 3.744；p=0.004）更优。尽管如此，中等尺寸CRLM的1年、3年和5年LC仍分别达到93.9%、85.4%和81.5%，且技术疗效随时间推移有所提升。 结论：对于中等尺寸不可切除的CRLM，热消融治疗是安全的，并能在绝大多数患者中实现长期局部控制。仍需通过COLLISION-XL试验（针对3–5 cm不可切除结直肠肝转移瘤的立体定向体部放疗与微波消融对比——一项II期随机对照试验）的结果，进一步明确局部消融方法在中等尺寸不可切除CRLM治疗中的作用。

原文链接：

Efficacy of Thermal Ablation for Small-Size (0–3 cm) versus Intermediate-Size (3–5 cm) Colorectal Liver Metastases: Results from the Amsterdam Colorectal Liver Met Registry (AmCORE)