Combined hepatic resection and ablation for high burden of colorectal liver metastases demonstrates safety and durable survival

医学 烧蚀 外科 热烧蚀 并发症 总体生存率 人口 切除术 胃肠病学 内科学 环境卫生
作者
Michael M. Wach,Laura Washburn,Jurgis Alvikas,Linda T. Qu,Michelle Zhang,Mark S. Etherington,Caroline J. Rieser,Tony Haykal,James F. Pingpank,Amer H. Zureikat,David A. Geller,Richard S. Hoehn,Samer Tohme
出处
期刊:Hpb [Elsevier BV]
卷期号:26 (3): 362-369 被引量:1
标识
DOI:10.1016/j.hpb.2023.11.002
摘要

Background Hepatic resection (HR) and thermal ablation of Colorectal Liver Metastases (CRLM) have each individually demonstrated safety and survival benefit. We sought to provide our experience with the combination of HR + ablation within one operation for patients with multiple CRLM. Methods Review of a single institution database of patients who underwent HR + ablation between 2010 and 2019. Results 161 patients were identified who underwent HR + ablation for isolated CRLM (mean age: 59, male 63.4%). 125 (77.6%) patients had bilobar disease and 92 (57.1%) patients had ≥5 tumors. 28 (17.4%) patients experienced minor (grade 1 or 2) complications while 20 (12.4%) had grade 3–5 complications. Patients who underwent simultaneous colon resection with HR + ablation had a higher complication rate (22 of 47, 46.8%) than those undergoing HR + ablation only (26 of 114, 22.8%, p = 0.002). Median and 5-year OS for all patients undergoing HR + ablation was 38.2 months and 33.2%, respectively. 5-year hepatic recurrence free survival was 23.5%. Patients with 5 or more tumors demonstrated no difference in median survival compared to those with fewer than 5 tumors (37.0 months vs 38.4 months, p = 0.326). Conclusions In this population of CRLM patients with a relatively high burden of disease, HR + ablation demonstrated an acceptable safety profile as well as durable long-term survival.
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