Avtor/Urednik		Horvat, Matjaž; Ivanecz, Arpad; Jagrič, Tomaž; Potrč, Stojan
Naslov		Radiofrekventna ablacija pri zdravljenju kolorektalnih metastaz
Tip		članek
Vir		In: Potrč S, editor. Razsejani rak debelega črevesa in danke: [standardi in novosti]. 1. Mariborski onkološki dan; 2008 nov 21; Maribor. Maribor: Oddelek za abdomininalno in splošno kirurgijo, Kirurška klinika, UKC,
Leto izdaje		2008
Obseg		str. 279-90
Jezik		slo
Abstrakt		Background: Surgical resection is the treatment of choice for colorectal metastases; however for various reasons, the vast majority of patients are not operative candidates. Several local ablative therapies have emerged as alternatives for resection or as addition in total oncologic care. Radiofrequency thermal ablation (RFA) is most widely employed liver directed treatment. Patients and methods: In a retrospective manner we examined the data of patients who underwent the treatment for colorectal metastases at our department in a five year period (2003 - 2008). The data were compared between the different groups involving radiofrequency ablation as regarding their outcome and survival. Results: 34 patients were treated in 48 sessions in various combinations of RFA (percutaneous RFA, open RFA, resection plus RFA and combinations with RFA). There were 16 males (average age 64.8, from 47 to 86 years) and 18 females (average age 61.6 from 48 to 80). The higher stadium of the primary tumor was found in the group of patients treated with resection plus RFA (p = 0.01). There was also a significant smaller number of metastases in the group treated with percutaneous RFA (p = 0.001), but there was no significant difference in the metastases size between the various groups. The surgical and non surgical complications were few (2 - 8 %) and no patient died. The median survival was highest in the percutaneous group (90 weeks) but no statistical differences were found as compared to the other groups. Conclusions: Although RFA has been readily adopted into treatment algorithm for colorectal metastases with promising results in selected cases more studies and trials are needed to define its therapeutic position in treatment for colorectal metastases.
Izvleček		Izhodišča: Kirurška resekcija je metoda izbora pri zdravljenju jetrnih zasevkov raka debelega črevesa in danke, vendar zaradi različnih vzrokov pri večini bolnikov ni izvedljiva. Poznamo številne lokalne ablativne metode kot alternativo kirurški resekciji ali dodatek onkološki oskrbi bolnika. Radiofrekventna ablacija (RFA) je najpogosteje uporabljana metoda pri zdravljenju jetrnih zasevkov. Bolniki in metode: Retrogradno smo pregledali podatke bolnikov, ki so se zdravili na našem oddelku zaradi jetrnih zasevkov raka debelega črevesa in danke v obdobju petih let (2003-2008). Primerjali smo podatke izhoda zdravljenja in preživetja med različnimi skupinami bolnikov, kjer smo v metodi zdravljenja uporabili RFA. Rezultati: Opravili smo 48 posegov RFA pri 34 bolnikih v različnih kombinacijah (perkutana RFA, odprta RFA, resekcija in RFA in RFA in kombinacije z RFA). Zdravili smo 16 moških; povprečna starost 64,8 let (47-86) in 18 žensk; povprečna starost 61,6 let (48-80). Višji stadij primarnega tumorja je bil v skupini zdravljenih z resekcijo in RFA (p=0,01). Ugotovili smo pomembno manjše število jetrnih zasevkov v skupini zdravljenih s perkutano RFA (p=0,01), vendar brez signifikantne razlike v velikosti jetrnih zasevkov med posameznimi skupinami. Kirurških in nekirurških zapletov je bilo malo (2-8 %) in noben bolnik ni umrl. Mediano preživetje je bilo največje v skupini s perkutanim RFA (90 tednov) brez statistične razlike v primerjavi z ostalimi skupinami. Zaključki: Rezultati zdravljenja jetrnih zasevkov raka debelega črevesa in danke z RFA so obetajoči pri izbranih primerih bolnikov in RFA ima svoje mesto v algoritmu zdravljenja le teh; potrebne pa so nove študije za natančnejše ovrednotenje RFA kot metode zdravljenja.
Deskriptorji		COLORECTAL NEOPLASMS NEOPLASM METASTASIS LIVER