Resekcija ili radiofrekventna ablacija metastaze kolorektalnog karcinoma u jetri

  • Damir Jašarović Clinical Hospital Center Zemun, Belgrade, Serbia
  • Dragoš Stojanović Clinical Hospital Center Zemun, Belgrade, Serbia
  • Nebojša Mitrović Clinical Hospital Center Zemun, Belgrade, Serbia
  • Dejan Stevanović Clinical Hospital Center Zemun, Belgrade, Serbia
DOI: https://doi.org/10.2298/2185
Ključne reči: colorectal neoplasms||, ||kolorektalne neoplazme, digestive system surgical procedures||, ||hirurgija digestivnog sistema, procedure, liver neoplasms||, ||jetra, neoplazme, neoplasm metastasis||, ||neoplazme, metastaze, catheter ablation, treatment outcome||, ||ablacija preko katetera lečenje, ishod,

Sažetak


Uvod/Cilj. Hirurška resekcija jetre predstavlja metod izbora u lečenju pojedinačnih metastaza kolorektalnog karcinoma u jetri kod odgovarajućih bolesnika. Radiofrekventna ablacija postaje sve popularnija metoda za lečenje metastaza u jetri. Cilj ove studije bio je da uporedi ishode bolesti kod bolesnika sa pojedinačnom metastazom kolorektalnog karcinoma u jetri koji su lečeni hirurškom resekcijom u odnosu na bolesnike koji su lečeni radiofrekventnom ablacijom (RFA). Metode. U ovoj retrospektivnoj studiji analizirani su bolesnici sa pojedinačnom metastazom kolorektalnog karcinoma u jetri koji su lečeni u KBC „Dr Dragiša Mišović“ u Beogradu u periodu od januara 2002. do decembra 2009. godine. Poređeni su ishodi bolesti nakon hirurške resekcije jetre i nakon RFA metastaza u jetri. Rezultati. Studijom je bilo obuhvaćeno 94 (67,1%) bolesnika podvrgnutih resekciji jetre, dok je 46 (32,9%) bolesnika lečeno radiofrekventnom ablacijom. Kod većine bolesnika (59,6%) podvrgnutih hirurškoj resekciji učinjena je major hepatektomija. Prosečna dužina praćenja bolesnika bila je 28,4 meseca. Utvrđeno je da RFA tumora predstavlja značajni prediktor dužine ukupnog preživljavanja (p = 0,002, OR 3,75, 95% CI 1,696–8,284), te da je duže preživljavanje bez tegoba bilo u grupi bolesnika sa resekcijom u poređenju sa RFA grupom (37,6 vs 22,3 meseca, p = 0,073). Prosečno ukupno preživljavanje iznosilo je 56,3 meseca u grupi bolesnika sa hirurškom resekcijom naspram 25,1 mesec u RFA grupi (p = 0,005). Zaključak. Kod odgovarajućih bolesnika sa pojedinačnom metastazom kolorektalnog karcinoma u jetri trebalo bi razmotriti hiruršku resekciju kad god je to izvodljivo, jer pruža duži period preživljavanja nego lečenje radiofrekventnom ablacijom.

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Objavljeno
2015/04/23
Broj časopisa
Vol. 71 Br. 6 (2014)
Rubrika
Originalni članak