Thermal Ablation for Colorectal Liver Metastases
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- BEPPU TORU
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- HORINO KEI
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- KOMORI HIROYUKI
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- SUGIYAMA SHINICHI
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- MASUDA TOSHIRO
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- HAYASHI HIROMITSU
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- OKABE HIROHISA
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- OHTAO RYU
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- IMSEUNG CHOI
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- HAYASHI NAOKO
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- WATANABE MASAYUKI
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
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- BABA HIDEO
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
Bibliographic Information
- Other Title
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- 大腸癌肝転移の熱凝固療法
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Abstract
Hepatic resection in combination with systemic chemotherapy is a standard treatment modality for colorectal liver metastases (CRLM). Recently, thermal ablation, including microwave coagulation therapy (MCT) and radiofrequency ablation (RFA), has been utilized in the treatment of unresectable and partially resectable CRLM. A review of the English language literature and a summary of our experiences in applying thermal ablation in the treatment of CRLM are described here. RFA is used worldwide, and MCT is primarily utilized in eastern countries. In using percutaneous and laparoscopic/open surgical RFA, local recurrence rates were16% and 4% for tumors < 3 cm, 26% and 22% for tumors between 3-5 cm, and 60% and 50% for tumors > 5 cm. In a large series of treatments which utilized RFA for liver tumors, the mortality and morbidity rates were only 0.3 and 7.2%, respectively. The incidence of tumor seeding after the use of RFA for the treatment of CRLM is as high as 1.4%. Cumulative 5-year survival rates were 29%-36% using MCT and 14%-35% using RFA for unresectable CRLM. Long-term survival data for resectable CRLM are unclear. In our experience, local recurrence rates were undetectable in following the treatment of 30 cases of CRLM (average tumor diameter : 1.7 cm, average observation period : 26 months) which were treated with surgical RFA combined with hepatic resection after efficacious systemic chemotherapy. In Conclusion : 1) thermal ablation can be applied to unresectable CRLM without perivascular invasion, and for tumors < 3 cm with a percutaneous or surgical approach, and for tumors < 5 cm with a surgical approach ; 2) RFA after effective chemotherapy can provide an extremely high local control rate ; and 3) the application of thermal ablation for resectable CRLM is still controversial due to the lack of sufficient evidence obtained from a randomized trial.
Journal
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- Thermal Medicine
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Thermal Medicine 24 (3), 83-89, 2008
Japanese Society for Thermal Medicine
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Details 詳細情報について
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- CRID
- 1390282680263604096
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- NII Article ID
- 10025539719
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- NII Book ID
- AN10084762
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- ISSN
- 18823750
- 18822576
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- NDL BIB ID
- 9664601
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed