| Liver cancer is a common malignancy in the world, including hepatocellular carcinoma and liver metastases, because of its insidious onset, most patients are diagnosed when the disease is already advanced, clinically suitable for surgery patients only 20%-25%.Metastatic liver cancer (MLC) in patients with gastrointestinal cancer cause of death in the forefront also called sarcomas, compared with primary liver cancer are rare. Secondary or multiple body organ called the origin of metastatic liver cancer refers to violations of the liver. According to statistics,60% of gastrointestinal cancer complicated by varying degrees of liver metastases. This may be related to liver hepatic artery and portal vein blood supply unique anatomical structure about once MLC occur, survival of patients will be significantly shortened. The current surgical treatment is still the most effective treatment of liver cancer treatment, after 5-year survival rate is gradually increased in the treatment of unresectable hepatocellular carcinoma, the status of interventional treatment is particularly important, microwave ablation as one of them, because of warming speed, high thermal efficiency, high temperature more uniform thermal field, regular shape, clear boundary complete coagulation necrosis zone advantages in widespread clinical application.Objective To explore therapeutic results of local microwave ablation for hepatic metastasis and the factors influencing the survival after microwave therapy.Methods The clinical data of 47 patients (73 liver metastatic lesions) with metastasis hepatic carcinoma who received microwave ablation (MWA) at the Affiliated Anhui Provincial Hospital of Anhui Medical University from January 2012 to August 2015 were retrospectively analyzed. Of the 47 patients,16 were with liver metastasis from colonic cancer,9 with liver metastasis from rectal cancer,14 with liver metastasis from gastric cancer, and 8 with liver metastasis from other cancers. The diameter of the metastasis lesion ranged from 1.5-13.0cm (mean,6.2±3.5cm). Complete ablation rate, local and distant recurrence rate and survival rate were evaluated respectively. Patients were followed up via phone call and out-patient examination. Survival analysis was evaluated by the Kaplan-Meier method, and the differences between survival rates were ascertained using the log-rank test. Significant variables from the univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazards model.Results The complete ablation(CA)rate which was used to evaluate the local therapeutic effects was 89.0%(65/73),with 100.0%(22/22),92.0%(23/25) and 76.9%(20/26) in a diameter of lesions≤3.0 cm,3.0-5.0 cm and≥5.0 cm respectively. The CA rate was lower in the group of a diameter of lesions>5.0 cm as compared with other two groups(P<0.05).The local recurrence rate was 15.4%(10/65),with 4.5%(1/22),13.0%(3/23) and 30.0%(6/20) in a diameter of lesions<3.0 cm,3.0-5.0 cm and>5.0 cm respectively. The new intrahepatic distant recurrence rate was 42.5% (20/47).The follow-up time after MWA was 1-36(25.1±8.2) months. During the follow-up period,1-year,2-year and 3-year cumulative survival rate was 74.5%、 48.9.0% and 27.7% respectively, with a median survival time of 20.0 months. Univariate analysis of prognostic factors indicated that tumor size, number of metastases, tumor cell differentiation and primary site of tumors had significant prognostic influence on overall survival, while age, sex and status of metastasis were not significant prognostic factors. Furthermore, multivariate survival analysis revealed that only number of metastases and primary site of tumors were identified as independent predictors of poor prognosis for hepatic metastases patients.Conclusion MWA treatment offers satisfactory local tumoricidal efficacy to liver metastasis from single lesion of Colorectal carcinoma and the patients with recurrence and new metastases can be therapy repeatedly to improve long-term survival and survival quality. |
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