中国实用外科杂志

中国实用外科杂志

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介入和热消融治疗胰腺神经内分泌肿瘤肝转移临床疗效及预后因素分析

吴梦飞1，宋华丹1，刘霄宇1，2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2，颜志平1，2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2，刘凌晓1，2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2   

  1. 1复旦大学附属中山医院介入科，上海200032；2上海市影像医学研究所，上海200032
  • 出版日期:2018-07-01 发布日期:2018-07-09

  • Online:2018-07-01 Published:2018-07-09

摘要：

目的    评估介入及热消融治疗胰腺神经内分泌肿瘤肝转移的临床疗效及预后因素。方法    回顾性分析2006年5月至2017年12月于复旦大学附属中山医院接受经肝动脉化疗栓塞（TACE）及热消融治疗的45例胰腺神经内分泌肿瘤肝转移病人的临床资料。结果    45例病人中无治疗相关死亡病例。中位总生存期（OS）为60.1（95%CI 14.181~106.086）个月，中位无进展生存时间（PFS）为18.3（95%CI 13.078~23.589）个月。1、3、5和7年总存活率分别为83.8%、65.3%、52.9%和37.0%。TACE的总有效率为71.5%，热消融治疗的总有效率为96.2%。COX多因素分析提示原发病灶切除是总生存期的独立预后因素（HR=0.358，95%CI 0.136~0.9412，P=0.037），原发病灶切除病人5年存活率为70.9%，而未行原发病灶切除者为32.5%。结论    TACE和热消融治疗对胰腺神经内分泌肿瘤肝转移病人安全有效。

关键词: 胰腺神经内分泌肿瘤, 肝转移, 经肝动脉化疗栓塞, 热消融, 总生存期

Abstract:

Interventional and thermal ablation in the treatment of liver metastases of pancreatic neuroendocrine neoplasms        WU Meng-fei*，SONG Hua-dan，LIU Xiao-yu，et al. *Department of Interventional Radiology，Zhongshan Hospital，Fudan University，Shanghai 200032，China
Corresponding author：LIU Ling-xiao，E-mail：liu.lingxiao@zs-hospital.sh.cn
Abstract    Objective    To assess the efficacy and prognostic factors of transcatheter arterial chemoembolization (TACE) and thermal ablation for liver metastases （LM）of pancreatic neuroendocrine neoplasms (pNENs). Methods    From May 2006 to December 2017，45 patients with pancreatic neuroendocrine neoplasms with liver metastases who underwent TACE and  radiofrequency ablation in Zhongshan Hospital，Fudan University were analyzed retrospectively. Results    No procedure-related deaths in all 45 patients. The median OS was 60.1 months. And the median PFS was 18.3 months. The 1-，3-，5-and 7-year OS rate was 83.8%, 65.3%, 52.9% and 37.0%，respectively. The effective rate of TACE and thermal ablation therapy were 71.5% and 96.2%. COX multivariate analysis showed that primary tumor resection (HR=0.358，95%CI 0.136-0.941，P=0.037) was independent prognostic factors for overall survival time. The 5-year OS rate of patients with primary lesion resection versus without primary lesion resection was 70.9% versus 32.5%. Conclusion    TACE and thermal ablation may be effective in patients with LM of pNENs.

Key words: pancreatic neuroendocrine neoplasms, liver metastases, transarterial chemoembolization, thermal ablation, overall survival