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대장암 및 직장암의 간 전이 시 고주파 온열치료의 단기 결과

Short-term Results of Radiofrequency Ablation for Liver Metastasis of Colorectal Cancer

대한대장항문학회지 2002년 18권 1호 p.53 ~ 58
최성일 ( Choi Sung-Il ) - 성균관대학교 의과대학 삼성서울병원 일반외과

장원영 ( Chang Weon-Young ) - 성균관대학교 의과대학 삼성서울병원 소화기내과
백광열 ( Paik Kwang-Yeol ) - 성균관대학교 의과대학 삼성서울병원 외과
이두석 ( Lee Doo-Seok ) - 성균관대학교 의과대학 삼성서울병원 소화기내과
오소향 ( Oh So-Hyang ) - 성균관대학교 의과대학 삼성서울병원 일반외과
김정한 ( Kim Jung-Han ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
허진석 ( Heo Jin-Seok ) - 성균관대학교 의과대학 삼성서울병원 외과학교실
이우용 ( Lee Woo-Young ) - 성균관대학교 의과대학 삼성서울병원 일반외과
김승훈 ( Kim Seung-Hoon ) - 성균관대학교 의과대학 진단방사선과학교실
이원재 ( Lee Won-Jae ) - 성균관대학교 의과대학 진단방사선과학교실
임효근 ( Lim Hyo-Geun ) - 성균관대학교 의과대학 진단방사선과학교실
임재훈 ( Lim Jae-Hoon ) - 성균관대학교 의과대학 진단방사선과학교실
조재원 ( Cho Jae-Won ) - 성균관대학교 의과대학 삼성서울병원 일반외과
전호경 ( Jun Ho-Kyung ) - 성균관대학교 의과대학 삼성서울병원 일반외과

Abstract


Purpose: Radiofrequency ablation (RFA) is emerging as a new therapeutic method for the management of hepatic malignancy. We report our experience on the use of this technique for the management of liver metastasis of colorectal cancer.

Methods: All 32 colorectal cancer patients with synchronous or metachronous liver metastasis treated with RFA from May 1999 to May 2001 were reviewed using retrospective method including chart review and telephone interview. All patients were followed up postoperatively to assess complications, complete necrosis, local recurrence, and survival rate.

Results: Forty-one RFA sessions were performed on 70 metastatic tumors in 32 patients. There were no treatment- related death. Two complications related with RFA treatment, one intrahepatic bleeding and one intrahepatic abscess, occurred in 41 sessions of RFA (6.2%). With a median follow-up of 13.5 months, tumors recurred in 7 of 70 lesions (10.0%) from 5 patients due to incomplete necrosis and intrahepatic new lesion or distant metastasis in 13 patients of 27 patients (51.9%) after complete necrosis. There were 5 deaths and the 2 year survival rate was 80.9%. Disease free survival was 90.1%, 75%, 26.4% in 6 months, 12 months and 24 months, respectively. Seven patients underwent liver resections successfully with the application of RFA for the residual lesions in the remaining contralateral lobe. In these patients, with 9.0 months median follow up, the disease recurred in 2 patients due to incomplete necrosis, while recurring in 2 patients after complete necrosis and 3 patients were survived without recurrence or distant metastasis.

Conclusions: Radiofrequency ablation is a safe, well-tolerated, and effective treatment for liver metastasis in colorectal cancer patients. The procedure can be used to treat the residual tumor load in the contralateral lobe following liver resection in those considered unresectable at first presentation. This new therapeutic strategy seems to increase surgical resectability in patients whose mass is determined unresectable. To approve the efficacy of RFA, more long-term follow up should be attempted.

키워드

결직장암;간전이;고주파 온열치료
Colorectal cancer;Liver metastasis;Radiofrequency ablation
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