PDF(Pubmed)
Abstract：
OBJECTIVE: Hepatic metastasis frequently occurs in patients who have undergone radical pancreatic resection for pancreatic cancer. Besides chemotherapy, various local treatment approaches targeting hepatic lesions have been explored. However, research on radiofrequency ablation (RFA) as a localized therapy for hepatic metastasis is limited. Therefore, we conducted this retrospective study to provide clinical evidence.
METHODS: This is a single-center, retrospective, cohort study. After radical pancreaticoduodenectomy, 32 patients developed metachronous hepatic metastasis with fewer than 3 lesions, the largest of which was less than 3 cm in diameter. These patients underwent combined treatment with chemotherapy and RFA. After 8 weeks of chemotherapy, patients received RFA for hepatic lesions. Additional chemotherapy was administered, and the patients\' tumor status and survival were monitored. The primary endpoint of this study was overall survival (OS). Factors affecting OS were analyzed using the Cox risk model.
RESULTS: Among the 32 patients, the mean OS was 28.4 months. Univariate and multivariate Cox regression analysis revealed that the time (in months) of liver metastasis (HR = 0.04, 95% CI: 0.01 to 0.19; P < 0.001), the number of liver metastases (HR = 7.08, 95% CI: 1.85 to 27.08, P = 0.004), and PD (progressive disease) response to the second round of chemotherapy (HR = 29.50, 95% CI: 1.46 to 597.27; P = 0.027) were independent predictors of poorer survival.
CONCLUSIONS: Combined therapy with RFA and chemotherapy is safe in patients with hepatic metastasis after radical pancreaticoduodenectomy. Early recurrence (≤12 months), three liver metastatic lesions, and a poor response to the second round of chemotherapy were associated with poor survival.
METHODS: This is a single-center, retrospective, cohort study. After radical pancreaticoduodenectomy, 32 patients developed metachronous hepatic metastasis with fewer than 3 lesions, the largest of which was less than 3 cm in diameter. These patients underwent combined treatment with chemotherapy and RFA. After 8 weeks of chemotherapy, patients received RFA for hepatic lesions. Additional chemotherapy was administered, and the patients\' tumor status and survival were monitored. The primary endpoint of this study was overall survival (OS). Factors affecting OS were analyzed using the Cox risk model.
RESULTS: Among the 32 patients, the mean OS was 28.4 months. Univariate and multivariate Cox regression analysis revealed that the time (in months) of liver metastasis (HR = 0.04, 95% CI: 0.01 to 0.19; P < 0.001), the number of liver metastases (HR = 7.08, 95% CI: 1.85 to 27.08, P = 0.004), and PD (progressive disease) response to the second round of chemotherapy (HR = 29.50, 95% CI: 1.46 to 597.27; P = 0.027) were independent predictors of poorer survival.
CONCLUSIONS: Combined therapy with RFA and chemotherapy is safe in patients with hepatic metastasis after radical pancreaticoduodenectomy. Early recurrence (≤12 months), three liver metastatic lesions, and a poor response to the second round of chemotherapy were associated with poor survival.
摘要：
目的：胰腺癌行根治性胰腺切除术的患者常发生肝转移。除了化疗,已经探索了针对肝脏病变的各种局部治疗方法。然而,关于射频消融（RFA）作为肝转移的局部治疗方法的研究有限。因此,我们进行了这项回顾性研究以提供临床证据.
方法：这是一个单中心，回顾性,队列研究。根治性胰十二指肠切除术后，32例患者发生异时性肝转移，病灶少于3个，其中最大的直径小于3厘米。这些患者接受了化疗和RFA的联合治疗。化疗8周后，患者因肝脏病变接受RFA治疗.进行了额外的化疗，监测患者的肿瘤状态和生存率。这项研究的主要终点是总生存期（OS）。使用Cox风险模型分析影响OS的因素。
结果：在32例患者中，平均OS为28.4个月.单因素和多因素Cox回归分析显示肝转移时间（以月为单位）（HR=0.04，95％CI：0.01至0.19；P<0.001），肝转移的数量（HR=7.08，95％CI：1.85至27.08，P=0.004），和PD（进行性疾病）对第二轮化疗的反应（HR=29.50，95％CI：1.46至597.27；P=0.027）是生存率较差的独立预测因素。
结论：对于胰十二指肠切除术后肝转移患者，RFA联合化疗是安全的。早期复发（≤12个月），三个肝转移性病变,对第二轮化疗的反应差与低生存率相关。
方法：这是一个单中心，回顾性,队列研究。根治性胰十二指肠切除术后，32例患者发生异时性肝转移，病灶少于3个，其中最大的直径小于3厘米。这些患者接受了化疗和RFA的联合治疗。化疗8周后，患者因肝脏病变接受RFA治疗.进行了额外的化疗，监测患者的肿瘤状态和生存率。这项研究的主要终点是总生存期（OS）。使用Cox风险模型分析影响OS的因素。
结果：在32例患者中，平均OS为28.4个月.单因素和多因素Cox回归分析显示肝转移时间（以月为单位）（HR=0.04，95％CI：0.01至0.19；P<0.001），肝转移的数量（HR=7.08，95％CI：1.85至27.08，P=0.004），和PD（进行性疾病）对第二轮化疗的反应（HR=29.50，95％CI：1.46至597.27；P=0.027）是生存率较差的独立预测因素。
结论：对于胰十二指肠切除术后肝转移患者，RFA联合化疗是安全的。早期复发（≤12个月），三个肝转移性病变,对第二轮化疗的反应差与低生存率相关。
