射频消融在老年结直肠癌肝转移治疗中的疗效分析

Clinical efficacy of radiofrequency ablation in treatment of colorectal cancer with liver metastasis in elderly patients

目的探讨射频消融(RFA)在老年结直肠癌肝转移治疗中的安全性和疗效。方法回顾性分析2013年1月至2017年6月在河南科技大学第四附属医院诊治的87例老年结直肠癌肝转移患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男55例,女32例;年龄70~78岁,中位年龄为74岁。根据肝转移灶治疗方式,将患者分为RFA组(48例)与切除组(39例)。观察两组患者围手术期情况。两组手术时间、术中出血量等比较采用t检验,并发症发生率、复发率等比较采用χ2检验,生存分析采用Kaplan-Meier法和Log-rank检验。结果RFA组平均手术时间、术中出血量、术后住院时间分别为(46±10)min、(29±9)ml、(2.5±0.3)d,明显低于切除组的(126±25)min、(301±80)ml、(7.3±1.8)d(t=-5.317,-7.233,-12.672;P<0.05)。RFA组并发症发生率为6%(3/48),明显低于切除组的23%(9/39)(χ^(2)=5.124,P<0.05)。RFA组中位生存时间为40个月,切除组为43个月,两组术后生存差异无统计学意义(χ^(2)=1.687,P>0.05)。结论对于老年结直肠癌肝转移患者,RFA治疗安全可靠,能达到和手术相近的治疗效果。

Objective To evaluate the safety and efficacy of radiofrequency ablation(RFA)in the treatment of colorectal cancer with liver metastasis in elderly patients.Methods Clinical data of 87 elderly patients with colorectal cancer with liver metastasis admitted to the Fourth Affiliated Hospital of Henan University of Science&Technology from January 2013 to June 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,55 patients were male and 32 female,aged from 70 to 78 years,with a median age of 74 years.According to the treatment methods of liver metastases,all patients were divided into the RFA group(n=48)and resection group(n=39).Perioperative conditions of patients between two groups were observed.The operation time and intraoperative blood loss were statistically compared between two groups by t test.The incidence of complications and recurrence rates were statistically compared between two groups by using Chisquare test.Survival analysis was performed by Kaplan-Meier method and Log-rank test.Results In the RFA group,the average operation time,intraoperative blood loss and length of postoperative hospital stay were(46±10)min,(29±9)ml and(2.5±0.3)d,respectively,significantly less than(126±25)min,(301±80)ml and (7.3±1.8)d in the resection group(t=-5.317,-7.233,-12.672;P<0.05).The incidence of complications in the RFA group was 6%(3/48),significantly lower than 23%(9/39)in the resection group(χ^(2)=5.124,P<0.05).The median survival time was 40 months in the RFA group,and 43 months in the resection group,where no significant difference was observed between two groups(χ^(2)=1.687,P>0.05).Conclusions RFA is a safe and reliable treatment for the elderly patients with colorectal cancer and liver metastasis,which can achieve equivalent efficacy to surgery.