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1.
R. Hompes S. Fieuws R. Aerts M. Thijs F. Penninckx B. Topal 《European journal of surgical oncology》2010
Aims
Microwave ablation (MWA) is the most recent development in the field of local ablative therapies. The aim of this study was to evaluate the variability and reproducibility of single-probe MWA vs. radiofrequency ablation (RFA) of liver metastases smaller than 3 cm in patients without underlying liver disease.Methods
Sixteen liver metastases were treated using MWA, and matched for size and localisation with 13 metastases treated by RFA. Tumour diameters and postoperative ablation diameters were recorded (D1 transverse; D2 antero-posterior; D3 cranio-caudal; mm) on computed tomography scans.Results
Median D1, D2, and D3 ablation diameters after MWA vs. RFA were 18.5 (12–64) vs. 34 (16–41) mm (p = 0.003), 26 (14–60) vs. 35 (28–40) mm (p = 0.046), and 20 (10–73) vs. 32 (20–45) mm (p = 0.025), respectively. As compared to RFA, the variability between the lesions after MWA was significantly higher for D2 (p < 0.0001) and D3 (p = 0.002) but not for D1 (p = 0.15). The ablation diameters were less uniform after MWA than after RFA (p < 0.001).Conclusion
Ablation diameters after single-probe MWA of metastatic liver tumours are highly variable and suboptimal. Improvements are needed before MWA can be implemented routinely. 相似文献2.
Shih-En Tseng Yi-You Chiou Yu-Chin Lee Reury-Perng Perng Whang-Peng Jacqueline Yuh-Min Chen 《Lung cancer (Amsterdam, Netherlands)》2014
Background
In patients with non-small cell lung cancer (NSCLC), the development of liver metastasis (LM) is a poor prognostic factor. Whether systemic treatment combined with local treatment for LM has benefit for NSCLC patients with LM is unknown.Methods
We retrospectively reviewed and analyzed the clinical data and tumor epidermal growth factor receptor (EGFR) mutation status of 673 pulmonary adenocarcinoma patients, including 85 patients who developed LM at any time point in the course of the disease. Radiofrequency ablation (RFA) with real-time ultrasonographic guidance was used for local treatment of LM in these patients, if appropriate.Results
Patients with an EGFR mutation were more prone to having synchronous LM than patients with EGFR wild-type (50.0% vs. 23.5%, P = 0.019). Fifty-six patients (65.9%) had ≦5 LM nodules. The median overall survival (OS) of patients with ≦5 LM nodules was 7.6 months compared with 2.9 months for those with multiple nodules (P < 0.001). The independent prognostic factors after LM were performance status, EGFR mutation, synchronous LM and LM numbers. The independent prognostic factors for patients with ≦5 LM nodules were performance status, EGFR mutation, LM concomitant with adrenal metastasis and having received RFA. Patients who received RFA treatment (n = 6) had longer OS after LM than those without RFA treatment (n = 42) (23.1 vs. 7.9 months, P = 0.035).Conclusions
We recommend that patients with a better performance status and ≦5 LM nodules be considered for systemic treatment combined with RFA when LM develops. 相似文献3.
Shaelyn Culleton Haiyan Jiang Carol R. Haddad John Kim Jim Brierley Anthony Brade Jolie Ringash Laura A. Dawson 《Radiotherapy and oncology》2014
Purpose
To report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).Methods and materials
A prospective study of SBRT was developed for patients with CP B7 or B8 unresectable HCC, <10 cm. Selected ineligible patients (e.g. CP > B8, >10 cm) treated off-study from 2004 to July 2012 were also reviewed. Patients were excluded if they were treated as a bridge-to-liver-transplant.Results
29 patients with CP B/C HCC were treated with SBRT (median dose 30 Gy in 6 fractions) from 2004 to December 2012. The majority had CP B7 liver function (69%) and portal vein tumor thrombosis (76%). The median survival was 7.9 months (95% CI: 2.8–15.1). Survival was significantly better in patients with CP = B7 and AFP ? 4491 ng/mL. Of 16 evaluable patients, 63% had a decline in CP score by ?2 points at 3 months.Conclusion
SBRT is a treatment option for selected HCC patients with small HCCs and modestly impaired (CP B7) liver function. 相似文献4.
Objective
To determine the prognostic value of K-ras mutations in plasma DNA of unresectable pancreatic cancer patients.Methods
Blood samples were collected from 91 patients with unresectable pancreatic cancer prior to treatment. K-ras gene was amplified from the circulating plasma DNA. Mutations were detected by direct sequencing. The relationship between the types of K-ras gene and prognosis of unresectable pancreatic cancer was evaluated.Results
K-Ras codon 12 mutations were found in 30 of 91(33%) plasma DNA samples, 17mutations were c.35G > A (p.G12D), 11 were c.35G > T (p.G12V) and only 2 were c.34G > C (p.G12R)). K-ras codon 12 mutations could significantly reflect the clinical parameters, including TNM tumor staging (P = 0.033) and liver metastasis (P = 0.014). The median survival time of patients with K-ras mutations was shorter than that of patients with wild-type K-ras gene (3.9 months vs. 10.2 months, P < 0.001). K-ras codon 12 mutation from plasma DNA was an independent negative prognostic factor for survival (hazard ratio, 7.39; 95% confidence interval, 3.69–14.89).Conclusion
K-ras mutation in plasma DNA is a predictive biomarker for a poor prognosis of unresectable pancreatic cancer patients. 相似文献5.
G.V. Scagliotti C. Gridelli F. de Marinis M. Thomas M. Dediu J.-L. Pujol C. Manegold B. San Antonio P.M. Peterson W. John N. Chouaki C. Visseren-Grul L.G. Paz-Ares 《Lung cancer (Amsterdam, Netherlands)》2014
Objectives
Two phase III trials of advanced NSCLC patients were compared to examine relative efficacy and safety of differing treatment regimens. The JMDB trial investigated first-line pemetrexed–cisplatin (pemetrexed 500 mg/m2 plus cisplatin 75 mg/m2 every 21 days; maximum: 6 cycles). The PARAMOUNT phase III trial compared maintenance pemetrexed versus placebo after patients with nonsquamous NSCLC completed 4 cycles of first-line pemetrexed–cisplatin without disease progression.Methods
Overall survival (OS) and progression-free survival (PFS), analyzed by Kaplan–Meier and Cox methods, and toxicity rates were compared between the PARAMOUNT arms and a selected homogeneous population from JMDB: 346 patients with disease and prior treatment characteristics matching the PARAMOUNT population.Results
Outcomes for the PARAMOUNT placebo arm were similar to the JMDB homogeneous group (median PFS: 5.6 versus 6.2 months, p = 0.117, HR = 1.16; median OS: 14.0 versus 14.2 months, p = 0.979, HR = 1.00). The PARAMOUNT maintenance pemetrexed group had statistically superior efficacy compared with the JMDB homogeneous group (median PFS: 7.5 versus 6.2 months, p < 0.00001, HR = 0.66; median OS: 16.9 versus 14.2 months, p = 0.003, HR = 0.75). Patients who received pemetrexed maintenance (median 4 cycles, range 1–44) following 4 cycles of pemetrexed–cisplatin exhibited a higher incidence of drug-related serious adverse events compared with JMDB patients (median 6 cycles of pemetrexed–cisplatin) (10.6% versus 2.9%); grade 3/4 fatigue and renal toxicity were also higher in the pemetrexed arm of PARAMOUNT.Conclusions
The across-trial comparison of a relevant JMDB study population with the two arms of the PARAMOUNT study supported the efficacy of the pemetrexed continuation maintenance strategy and suggested the results are not influenced by limiting the pemetrexed–cisplatin induction treatment to four cycles. Although longer exposure to pemetrexed–cisplatin or maintenance pemetrexed increased some toxicities, the overall incidence remained low, underscoring the relative safety of these treatment regimens. 相似文献6.
R.M. Eisele J. ZhukowaS. Chopra S.C. SchmidtU. Neumann J. PratschkeG. Schumacher 《European journal of surgical oncology》2010
Introduction
Liver tumors should be surgically treated whenever possible. In the case of bilobar disease or coexisting liver cirrhosis, surgical options are limited. Radiofrequency ablation (RFA) has been successfully used for irresectable liver tumors. The combination of hepatic resection and RFA extends the feasibility of open surgical procedures in patients with liver metastases and hepatocellular carcinoma (HCC).Patients and methods
RFA was performed with two different monopolar devices using ultrasound guidance. Intraoperative use of RFA for the treatment of liver metastases or HCC was limited to otherwise irresectable tumors during open surgical procedures including hepatic resections. Irresectability was considered if bilobar disease was treated, the functional hepatic reserve was impaired or appraised marginal for allowing further resection.Results
Ten patients with both liver metastases and HCC, and two patients with cholangiocellular carcinoma were treated. Complete initial tumor clearance was achieved in all patients. Two patients of the metastases group and five patients of the HCC group suffered from local recurrence after a median of 12 months (1–26) (local recurrence rate 32%). Five patients of the metastases group and six patients of the HCC group developed recurrent tumors in different areas of the ablation site after a median time of 4 months (2–18) (distant intrahepatic recurrence in 55%). Survival at 31 months was 36%.Conclusion
RFA extends the scope of surgery in some candidates with intraoperatively found irresectability. 相似文献7.
Z.-W. Peng H.-H. Liang M.-S. Chen Y.-J. Zhang J.-Q. Li Y.-Q. Zhang W.Y. Lau 《European journal of surgical oncology》2008
Aims
This study aimed to evaluate the efficacy and safety of percutaneous radiofrequency ablation (PRFA) for hepatocellular carcinoma (HCC) in the caudate lobe.Patients and methods
Between January 2001 and December 2006, 17 patients (twelve males and five females) who were between 33 and 68 years old (mean 54.3), with caudate lobe HCC [2.0–6.5 cm in diameter (mean 3.1)] were treated with either PRFA alone (n = 14), or PRFA with percutaneous ethanol injection (n = 3) under ultrasound guidance. The right or the anterior approach was used in 12 and 5 patients, respectively.Results
All procedures were performed successfully. There was no mortality and major morbidity due to PRFA. Fourteen tumors (82%) were completely ablated after one to two sessions of treatment. During follow-up (range 3–60, mean 29.1 months), two (14%) developed local recurrence. Intrahepatic metastases developed in 9 of 17 patients (53%). No distant metastasis was found. Four patients died (24%), 3 from tumor progression and 1 from hepatic failure. The 1-, 2-, and 4-year overall survivals were 88%, 80%, and 72%, respectively, and the progress free survivals were 47%, 20%, and 10%, respectively.Conclusions
PRFA is efficacious and safe for patients with HCC in the caudate lobe. 相似文献8.
Background
Traditionally, a staged operative approach has been used for patients with synchronous colorectal cancer and liver metastases in the U.K. With improved outcomes from hepatic resection the role of a synchronous operative approach needs re-evaluated.Methods
32 consecutive patients with colorectal cancer and hepatic metastases that underwent a synchronous operative approach were individually case matched (according to: age; sex; ASA grade; type of hepatic and colonic resection) with patients that had undergone a staged approach. The following variables were analysed: operative blood loss; in hospital morbidity and mortality; duration of hospital stay; disease free and overall survival.Results
Operative blood losses were: synchronous group, median 475 mL (range 150–850 mL) vs median 425 mL (range 50–1700 mL), (p > 0.050). There were no significant differences in morbidity: (34% synchronous group vs 59%, p = 0.690) with no recorded mortality. Synchronous group had a shorter hospital stay (median 12 days [range 8–21] vs 20 [range 7–51], p = 0.008). There were no statistical differences between synchronous and staged patients for disease free and overall survival: 10 months (95% CI 5.8–13.7) versus 14 (95% CI 12.2–16.3; p = 0.487) and 21% versus 24% at 5 years (p = 0.838).Conclusion
This present study provides supporting evidence for synchronous operative procedures in patients with colorectal liver metastases. 相似文献9.
J.K. Pine K.G. Fusai R. Young D. Sharma B.R. Davidson K.V. Menon S.H. Rahman 《European journal of surgical oncology》2009
Background
The prognostic role of serum C-reactive protein in pancreatic cancer has received increasing attention; however the confounding effects of biliary obstruction have not been addressed in previous studies. We sought to determine the prognostic importance of serum CRP prior to biliary intervention in the prognosis of pancreatic adenocarcinoma.Methods
A retrospective case note review of patients diagnosed with pancreatic cancer between 2001 and 2006. Clinical, radiological and biochemical criteria were correlated with overall survival. Patients were divided into: Group 1 who underwent potentially curative resection, and Group 2 with advanced unresectable disease managed non-surgically.Results
In total, 199 patients were included (58 resected). The proportion of patients with biliary obstruction was equal in both groups. Serum CRP and serum bilirubin concentration at presentation were significantly higher among patients in Group 2 compared to Group 1 (P values). On multivariate analysis, advancing age (P = 0.012) and raised serum CRP concentration were independently associated with overall survival only in Group 2 patients (P = 0.027, 95% CI 0.31–0.93). This association was independent of biliary tract obstruction.Conclusion
Raised serum C-reactive protein concentration at the time of presentation of advanced pancreatic cancer carries a poor prognosis independent of biliary tract obstruction. 相似文献10.
J.-Q. Dan Y.-J. Zhang J.-T. Huang M.-S. Chen H.-J. Gao Z.-W. Peng L. Xu W.Y. Lau 《European journal of surgical oncology》2013
Background and purpose
Reactivation of hepatitis B virus (HBV) happens after systemic chemotherapy, transarterial chemoembolization (TACE) or hepatic resection for HBV-related hepatocellular carcinoma (HCC) patients. The incidence and risk factors of HBV reactivation after radiofrequency ablation (RFA) are unclear.Patients and methods
From August 2006 to August 2011, 218 consecutive patients with HBV-related small HCC treated with RFA (n = 125) or hepatic resection (n = 93) were retrospectively studied. The incidence of HBV reactivation and risk factors were analyzed.Results
HBV reactivation developed in 20 (9.2%) patients after treatment. The incidence of HBV reactivation was significantly lower in the RFA group (5.6%, 7/125) than the hepatic resection group (14.0%, 13/93, P = 0.034). On univariate and multivariate analyses, no antiviral therapy (OR 11.7; 95% CI 1.52–90.8, P = 0.018) and treatment with RFA/hepatic resection (OR3.36; 95% CI 1.26–8.97, P = 0.016) were significant risk factors of HBV reactivation. On subgroup analysis, the incidence of HBV reactivation was lower in patients who received antiviral therapy than those who did not receive antiviral therapy in both the hepatic resection group (2.9% vs. 20.7%, P = 0.027) and the RFA group (0% vs. 7.6%, P = 0.188), although the difference was not significant in the latter group.Conclusion
The incidence of HBV reactivation after RFA was relatively low when compared with hepatic resection. Prophylactic antiviral therapy is recommended, especially for patients who are going to receive hepatic resection for HBV-related HCC to decrease the incidence of post-treatment HBV reactivation. 相似文献11.
Tanja Alderliesten Anja BetgenPaula H.M. Elkhuizen Corine van Vliet-VroegindeweijPeter Remeijer 《Radiotherapy and oncology》2013
Purpose
To investigate the heart position variability in deep-inspiration breath-hold (DIBH) radiation therapy (RT) for breast cancer when 3D surface imaging would be used for monitoring the BH depth during treatment delivery. For this purpose, surface setup data were compared with heart setup data.Materials and methods
Twenty patients treated with DIBH-RT after breast-conserving surgery were included. Retrospectively, heart registrations were performed for cone-beam computed tomography (CBCT) to planning CT. Further, breast-surface registrations were performed for a surface, captured concurrently with CBCT, to planning CT. The resulting setup errors were compared with linear regression analysis. Furthermore, geometric uncertainties of the heart (systematic [Σ] and random [σ]) were estimated relative to the surface registration. Based on these uncertainties planning organ at risk volume (PRV) margins for the heart were calculated: 1.3Σ − 0.5σ.Results
Moderate correlation between surface and heart setup errors was found: R2 = 0.64, 0.37, 0.53 in left–right (LR), cranio-caudal (CC), and in anterior–posterior (AP) direction, respectively. When surface imaging would be used for monitoring, the geometric uncertainties of the heart (cm) are [Σ = 0.14, σ = 0.14]; [Σ = 0.66, σ = 0.38]; [Σ = 0.27, σ = 0.19] in LR; CC; AP. This results in PRV margins of 0.11; 0.67; 0.25 cm in LR; CC; AP.Conclusion
When DIBH-RT after breast-conserving surgery is guided by the breast-surface position then PRV margins should be used to take into account the heart-position variability relative to the breast-surface. 相似文献12.
Introduction
Previous studies have included Hürthle cell carcinoma (HCC) as a variant of follicular thyroid carcinoma in analysis of clinical outcome and others have failed to adequately distinguish between benign and malignant Hürthle cell neoplasms. The aim of this study was to report our experience of histologically confirmed malignant HCC, identifying patient, tumour and treatment factors that predict outcome.Methods
A retrospective review was undertaken of all patients treated with HCC between 1946 and 2003. Study end-points were disease-free survival (DFS) and cause-specific survival (CSS). Demographic, pathological and treatment-related factors were all correlated with the study end-points.Results
Sixty-two patients were followed up for a median (range) of 58 months (2–629). On multivariate analysis, only extent of surgery (p < 0.001) was an independent factor affecting CSS. Lymph node status (p = 0.008), presence of metastases at diagnosis (p = 0.005) and tumour stage (p = 0.009) were independent predictors of DFS.Conclusions
HCC appears to be a separate entity from follicular thyroid carcinoma (FTC), with a more aggressive disease profile. Lymph node status, tumour stage, and the presence of metastases are independent predictors of DFS. Radical surgery may improve outcome in HCC. 相似文献13.
Ligy Thomas Mike Drinnan Basavaiah Natesh Hisham Mehanna Terry Jones Vinidh Paleri 《Cancer treatment reviews》2012
Background
Different modalities of treatment in early laryngeal cancer lead to equivalent oncological outcomes. Hence this systematic review was undertaken to synthesise the key oncological outcomes following primary open partial laryngectomy for laryngeal cancer.Methods
A systematic review of the English literature with statistical pooling of outcomes, the main outcome measure being local control at 24 months.Results
A total of 53 articles satisfied inclusion criteria and were included in the review. The pooled local control rate at 24 months from 5061 patients was 89.8% (95% CI 88.3–91.2), pooled overall survival was 79.7% (n = 3967; 95% CI 76.5–782.8) and pooled mean disease free survival was 84.8% (n = 2344; 95% CI 80.6–88.7). The pooled mean operative mortality, laryngectomy for function, tracheostomy decannulation and permanent gastrostomy rates were 0.7%, 1.7%, 96.3%, and 2.0%, respectively.Conclusions
Open conservation laryngectomy is a good option in selected primary laryngeal cancers with excellent oncological outcomes. 相似文献14.
A. Casaril M. Abu Hilal A. Harb T. Campagnaro G. Mansueto N. Nicoli 《European journal of surgical oncology》2008
Introduction
Radiofrequency ablation (RFA) has become widely accepted as an important adjunct, and sometimes a viable alternative, to liver surgery. The aims of this study are to assess the risks associated with percutaneous RFA and to discuss the indications and contraindications to its use.Patients and methods
This is a review of 130 consecutive patients who were treated for primary (n = 92) and metastatic (n = 38) liver tumours. Only complications after percutaneous RFA (83 patients) were evaluated. Interesting case studies are included to highlight potential complications following RFA and their management.Results
One patient died of perforation of the colon and five others had major complications. There were 15 minor complications. Local recurrence rates reached 30% overall, and a further 25 patients developed a new hepatic lesion, different from the one treated by RFA. Median disease-free survival was 13 months. Overall survival rates at 1, 2 and 5 years were 85.3%, 71.3% and 57.6%, respectively.Conclusion
Percutaneous RFA is a safe and efficient technique but not free of complications and with potential fatal outcome. It is also associated with significant local recurrence rates. The procedure should only be performed following adequate training and the indication should always be discussed in multidisciplinary meetings. Patient's liver function and general health as well as tumour size and position must be considered. Intraoperative or video laparoscopic RFA is useful for superficial tumours in order to avoid damage to viscera surrounding the liver surface. 相似文献15.
Purpose
Large tumor motion leads to large treatment volumes with an Internal Target Volume (ITV) based approach, whereas mid-ventilation (MidV) based Planning Target Volumes (PTV) margins typically lead to smaller treatment volumes. The purpose of this study was to evaluate the MidV approach on clinical outcome data of Stereotactic Body Radiotherapy (SBRT) in NSCLC.Methods and materials
297 patients with 314 peripheral tumors treated from 2006 to 2012 were retrospectively analyzed. In all patients a 4D-CT was acquired and the MidV-CT-scan was selected. Tumor amplitudes were determined in left–right (LR), cranio–caudal (CC) and anterior–posterior (AP) direction, to calculate patient specific PTV margins.Results
The median LR, CC and AP tumor amplitudes were 2 mm (0–16 mm), 4 mm (0–39 mm) and 3 mm (0–18 mm), respectively, yielding a median CTV-to-PTV margin of 8 mm. An ITV + 5 mm based PTV margin would have been bigger in 47% of the patients. After a median follow up of 22 months, local recurrence occurred in six patients (2%). Two year LC and OS were 98% and 67%, respectively.Conclusions
Using the MidV approach combined with online image guidance an excellent LC of 98% was established with SBRT. This provides clinical support that incorporating respiratory motion into the PTV margin is a safe approach. 相似文献16.
Benedikt Engels Guy Soete Thierry Gevaert Guy Storme Dirk Michielsen Mark De Ridder 《Radiotherapy and oncology》2014
Background and purpose
A previous study in our department demonstrated the negative impact on freedom from biochemical failure (FFBF) of using too narrow planning target volume (PTV) margins during prostate image-guided radiotherapy (IGRT). Here, we investigated the impact of appropriate PTV margins and rectal distention on FFBF.Methods and materials
A total of 50 T1-T3N0M0 prostate cancer patients were treated with daily IGRT by implanted markers. In the first 25 patients, PTV margins were 3 mm laterolateral, 5 mm anterioposterior and 4 mm craniocaudal. The subsequent 25 patients were treated with isotropic margins of 6 mm. The rectal cross-sectional area (CSA) was determined on the planning CT. Median follow-up was 61 months.Results
The overall 5-year FFBF was 83%. A 6 mm PTV margin was related to increased 5-year FFBF on univariate analysis (96% vs 74% with the tighter PTV margins, p = 0.04). The 5-year FFBF of patients with a rectal distention on the planning CT was worse compared to those with limited rectal filling (75% for CSA ? 9 cm2 vs 89% for CSA < 9 cm2, p = 0.02), which remained significant on multivariate analysis (p = 0.04).Conclusion
This retrospective study illustrated the positive impact of PTV margin adaptation and addressed the importance of avoiding rectal distention at time of the planning CT. 相似文献17.
Roman Dunavoelgyi Martin Zehetmayer Andreas Gleiss Wolfgang Geitzenauer Karl Kircher Dietmar Georg Ursula Schmidt-Erfurth Richard Poetter Karin Dieckmann 《Radiotherapy and oncology》2013
Purpose
To evaluate long-term safety and efficacy of hypofractionated stereotactic photon radiotherapy with 5 five fractions at 10 Gy each in patients with centrally located choroidal melanoma.Materials and Methods
Ninety-one patients with centrally located choroidal melanoma were treated stereotactically at a linear accelerator with 6 MV photon beams with 5 fractions at 10 Gy each. Examinations were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and yearly thereafter. Median follow-up was 37.8 months (IQR 19.2–49.9). They included visual acuity assessment, routine ophthalmological examinations with fundoscopy, echography for measurement of tumor dimensions, medical examinations and, if necessary, fluorescein angiography.Results
Initial tumor base diameters, height and volume were 11.20 mm (IQR 9.10–13.70), 9.80 mm (IQR 7.80–11.70), 4.53 mm (IQR 3.33–6.43) and 253.8 mm3 (IQR 127.5–477.0).Local tumor control and eye retention rates were 97.7% and 86.4% after 5 years, respectively. Eight patients developed metastatic disease and 3 of them died due to metastatic disease during the follow-up period. Median visual acuity decreased from 0.67 initially to 0.05 at the last individual follow-up (p < 0.001).The most common toxicities (any grade) were radiation retinopathy (n = 39), optic neuropathy (n = 32), radiogenic cataract (n = 21), neovascular glaucoma (n = 15) and dry eye syndrome (n = 10). The 5 year probabilities to remain free of these side effects (any grade) were 26.0%, 45.4%, 55.4%, 72.6% and 80.5%, respectively. The most important prognostic factors for toxicities were the largest tumor base diameter, tumor height and tumor distance to the optic disk.Conclusion
Hypofractionated stereotactic photon radiotherapy with a total dose of 50 Gy delivered in 5 fractions is a highly effective treatment option in patients with centrally located choroidal melanoma and has a moderate toxicity profile. 相似文献18.
K. Jiang W. Zhang M. Su Y. Liu X. Zhao J. Wang M. Yao J. Ogbonna J. Dong Z. Huang 《European journal of surgical oncology》2013
Objective
Surgical resection in the treatment of hepatocellular carcinoma (HCC) originating in the caudate lobe is challenging because of its deep location in the liver and possibly worse prognosis. We evaluated the overall survival of patients with solitary caudate small HCC who underwent laparoscopic radiofrequency ablation (RFA).Methods
This is a retrospective study on patients who underwent laparoscopic RFA (RFA) for solitary small HCC.Results
Twenty-seven (27) patients underwent laparoscopic caudate lobe RFA for solitary small HCC. The average tumor size was 2.8 cm. The overall survival rates were 96.3%, 88.9%, 74.1%, 74.1% and 62.9% at 1, 2, 3, 4 and 5 years respectively. The disease-free survival after RFA was 92.6%, 52.9%, 44.4%, 33.3% and 33.3% at 1, 2, 3, 4 and 5 years respectively. Most common postoperative complication was pleural effusion (7/27, 25.9%), and followed by transient hemoglobinuria (2/27, 7.4%).Conclusions
Laparoscopic RFA for caudate lobe small HCC is a safe and feasible procedure without perioperative mortality. Through a systematic review of other therapeutic options on caudate HCC, its overall outcome is comparable to that of surgical resection. 相似文献19.
J. Sakata Y. ShiraiT. Wakai K. KanekoM. Nagahashi K. Hatakeyama 《European journal of surgical oncology》2008
Aims
Vascular invasion is an established adverse prognostic factor in hepatocellular carcinoma (HCC). The aim of the current study was to identify the preoperative predictors of vascular invasion in patients undergoing partial hepatectomy for HCC.Methods
A retrospective analysis of 227 consecutive patients who underwent partial hepatectomy for HCC was conducted. Vascular invasion was defined as gross or microscopic involvement of the vessels (portal vein or hepatic vein) within the peritumoral liver tissue.Results
Seventy-six (33%) patients had vascular invasion. Among the preoperative factors, only the tumour size (relative risk, 16.78; p < 0.01) and the serum α-fetoprotein (AFP) level (relative risk, 3.57; p < 0.01) independently predicted vascular invasion. As the tumour size increased, the incidence of vascular invasion increased: ≤2 cm, 3%; 2.1–3 cm, 20%; 3.1–5 cm, 38%; and >5 cm, 65%. The incidence of vascular invasion was 32% in patients with serum AFP levels ≤1000 ng/mL, compared to 61% in patients with higher serum AFP levels (p < 0.01). Patients with both tumours >5 cm and serum AFP levels >1000 ng/mL had an 82% incidence of vascular invasion.Conclusions
The tumour size and serum AFP level, alone or in combination, are useful in predicting the presence or absence of vascular invasion before hepatectomy for HCC. 相似文献20.
Chun Chen Wilma Uyterlinde Jan-Jakob Sonke Josien de Bois Michel van den Heuvel José Belderbos 《Radiotherapy and oncology》2013