Objective: To compare the efficacy and safety of colorectal resection combined with simultaneous radiofrequency ablation (RFA) in the treatment of synchronous colorectal liver metastases(SCRLM). Methods: This retrospective study involved the patients admitted between January 1st 2010 and September 1st 2013. A total of 20 patients who underwent colorectal resection combined with simultaneous RFA of SCRLM were enrolled. Those patients (RFA group) were matched with 20 patients (Resection group) who underwent simultaneous resections of colorectal cancer and SCRLM based on the propensity scores. Perioperative parameters and survival outcomes were compared between the two groups. Results: The RFA and Resection groups were comparable in demographics, cancer characteristics and chemotherapy treatment (all P>0.05). The estimated blood loss and intraoperative blood transfusions in the RFA group were significantly lower than those in the resection group [150.00(100.00-200.00) vs 200.00(112.50-650.00), 1 vs 7, all P>0.05]. The postoperative stay in the RFA group was significantly shorter than that in laparoscopic group [8.50(8.00-10.75) vs 11.00(8.25-14.25), P=0.043]. There was no significant difference in postoperative complications (P>0.05). The 3-year disease free survival rate was 14.00% in the RFA group, and 31.20% in the Resection group (P=0.047). However, the 3-year overall rates were similar between the two groups (P>0.05). Conclusions: Compared with simultaneous resections of colorectal cancer and SCRLM resections, colorectal resection combined with simultaneous RFA of SCRLM was associated with less surgical blood loss and shorter hospitalization. Although inferior to simultaneous resections of colorectal cancer and SCRLM resections in survival outcomes, this approach extends the capability of delivering potentially curative treatment for colorectal cancer patients with unresectable SCRLM.
目的： 观察结直肠癌切除联合射频消融(RFA)治疗同时性结直肠癌肝转移的结果和预后。 方法： 收集2010年1月1日至2013年9月1日间解放军总医院收治的结直肠癌切除联合射频消融病例20例，将其与同时期接受同期结直肠癌与肝转移灶切除术的病例进行倾向性匹配，所得病例分别构成RFA组和手术切除组。比较两组临床病理特征、围手术期和长期随访结果。 结果： 两组一般临床病理资料差异均无统计学意义(均P>0.05)。RFA组术中估计出血量和术中输血例数均显著低于手术切除组[150.0(100.0～200.0)与200.0(112.5～650.0), 1与7,均P<0.05]。RFA组术后住院时间显著短于手术切除组[8.50(8.00～10.75)与11.00(8.25～14.25), P＝0.043]。两组术后并发症发生率差异无统计学意义(P>0.05)。RFA组3年无病生存率低于手术切除组(14.0%与31.2%, P＝0.047)，3年总体生存率与手术切除组接近(P>0.05)。 结论： 结直肠癌切除联合射频消融术与同期切除手术相比，能显著降低术中出血量，缩短住院时间。尽管患者总体预后不如同期切除手术，但该治疗方法为不适合手术切除的同时性结直肠癌肝转移患者提供了潜在治愈的可能。.
Keywords: Colorectal cancer; Liver metastases; Radiofrequency ablation.