Analyses of local control and survival after stereotactic body radiotherapy for pulmonary oligometastases from colorectal adenocarcinoma

Yamamoto, Takaya; Niibe, Yuzuru; Matsumoto, Yasuo; Oda, Hiroshi; Aoki, Masahiko; Nishikawa, Atsushi; Oh, Ryoong‐Jin; Satō, Takashi; Yahara, Katsuya; Ozaki, Masatoki; Manabe, Yoshihiko; Jingu, Keiichi

doi:10.1093/jrr/rraa071

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…Stereotactic body radiotherapy (SBRT) is one of the most frequently applied methods of treatment in medically inoperable patients. The efficacy of SBRT in terms of 3-year OS was reported by Agolli [23], Wegner et al [24], and Yamamoto et al [25] at 50.8%, 58%, 63.4% respectively. Relatively lower efficacy of SBRT in these studies is probably associated with radioresistance of colorectal cancer metastases compared to secondary deposits from other tumors -local progression rates are in the range of 42% vs. 16% [8].…”

Section: Oligometastatic Diseasementioning

confidence: 77%

Microwave ablation of colorectal cancer lung metastases — the first experience in Poland

et al. 2023

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Introduction. This study aimed to present the results of the first experiences in thermal ablation of colorectal cancer lung metastases in Poland.Material and methods. Seven patients with colorectal cancer lung metastases were treated with CT-guided microwave ablation. One of them was lost to follow-up, so 6 patients with 7 metastatic foci were included in this study. The mean diameter of lesions was 15 mm (10-20 mm). The patients were disqualified from surgical treatment due to comorbidities.Results. The mean duration of follow-up was 15 months (range: 6-29). No mortality was noted during that period.Local progression was not reported, while distant progression was found in two patients. Two patients presented with pneumothorax just after the ablation, and one of them required chest tube drainage. No complications were noted.Conclusions. Patients with a few small colorectal cancer lung metastases can benefit from thermal ablation. The method is safe and should be available for medically inoperable patients with pulmonary oligometastatic disease.

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Section: Oligometastatic Diseasementioning

confidence: 77%

Microwave ablation of colorectal cancer lung metastases — the first experience in Poland

et al. 2023

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“…Unfortunately, there is no reliable biomarker for OD and no universally accepted definition [ 10 ]. In most studies, OD was arbitrarily defined as a condition in which there are five metastases or less in imaging studies that are technically treatable with MDT [ 7 ]. In this study, we suggest adding metastases clonal origin to the definition of OD to identify those patients with greatest chance for cure by MDT.…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that SABR provided good palliation, but in most patients produced no cure [ 6 ]. Review of the literature in prostate cancer shows that MDT demonstrates high local control but only a small proportion of the patients remain without progression after 2 years [ 7 ]. When the OD concept was employed in renal cell carcinoma, local results were good with 1-year in-field progression free survival of 70%, but only 39% 1-year out of field progression free survival [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types

Gofrit

Roditi

et al. 2023

Discov Onc

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Background Oligometastatic disease (OD) is usually defined arbitrarily as a condition in which there are ≤ 5 metastases. Given limited disease, it is expected that patients with OD should have better prognosis compared to other metastatic patients and that they can potentially benefit from metastasis-directed therapy (MDT). In this study, we attempted to redefine OD based upon objective evidence that fulfill these assumptions. Methods Chest CTSs of 773 patients with 15,947 lung metastases originating from ten malignancy types were evaluated. The number and largest diameter of each metastasis was recorded. Metastatic cluster was defined as a cluster of two or more metastases with diameter difference ≤ 1 mm. The prognostic power of seven statistical models on overall survival (OS) was analyzed. Findings Both the number of metastases and metastatic clusters had a highly significant impact on OS (p < 0.0001, p = 0.003 respectively). Patients with a single metastasis or a single cluster of metastases (regardless of metastases number), equaling 16.2% of all patients, had significantly better prognosis compared to other patients (p = 0.0002). If metastases diameter variability is ignored, as in the standard definition of OD, then patients with 2–5 and 6–10 metastases would have a similar prognosis. Interpretation Patients with a single cluster of metastases, theoretically originating from a single clone, have significantly better prognosis compared to patients with more than one cluster. Using this definition can potentially improve the results of MDT. The upper limit of metastases number should be determined by the technical capabilities of the MDT used.

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“…For colorectal pulmonary metastases treated with SABR, reported 2‐, 3‐ and 5‐year local control rates are 75%, 6 60%, 7 and 56%, 8 respectively. These local control rates are lower than those reported for primary lung tumors, 9 and these findings are relevant since local control following SABR correlates with overall survival (OS) 10,11 . In comparison, the 5‐year local control rate after nonanatomical surgical resection for colorectal pulmonary metastases (CRPM) is reported to be 79%–82% 12,13 …”

Section: Introductionmentioning

confidence: 94%

“…These local control rates are lower than those reported for primary lung tumors, 9 and these findings are relevant since local control following SABR correlates with overall survival (OS). 10,11 In comparison, the 5-year local control rate after nonanatomical surgical resection for colorectal pulmonary metastases (CRPM) is reported to be 79%-82%. 12,13 For patients who develop a local recurrence after SABR for pulmonary metastases, treatment options commonly considered include palliative systemic therapy and reirradiation.…”

Section: Introductionmentioning

confidence: 99%

Salvage surgery for local recurrences after stereotactic ablative radiotherapy of colorectal pulmonary metastases

Dorp

Ünal

Gooijer

et al. 2023

Journal of Surgical Oncology

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IntroductionLocal control following stereotactic ablative radiotherapy (SABR) for patients with colorectal pulmonary metastases is reportedly lower than for metastases from other tumors. Such recurrences may still be amenable to salvage therapy. We describe our experience with salvage surgery in 17 patients.MethodsPatients who underwent salvage metastasectomy for a local recurrence following SABR for colorectal pulmonary metastases were identified from the surgical institutional databases of three Dutch major referral hospitals. Kaplan–Meier survival analysis was performed to determine survival.ResultsSeventeen patients underwent 20 salvage resections for local recurrence of colorectal pulmonary metastases. All patients had a progressive lesion on consecutive CT scans, with local uptake on 18fluorodeoxyglucose‐positron emission tomography computed tomography (FDG‐PET CT), and were discussed in a thoracic oncology tumor board. Median time to local recurrence following SABR was 20 months (interquartile range [IQR]: 13−29). Fourteen procedures were performed minimally invasively. Extensive adhesions were observed during three procedures. A Clavien–Dindo grade III–IV complication occurred after four resections (20%). The 90‐day mortality was 0%. The estimated median overall survival and progression‐free survival following salvage resection were 71 months (confidence intervals [CI]: 50–92) and 39 months (CI: 19–58), respectively. Salvage resections were significantly more extensive, compared to the potential resection assessed on pre‐SABR imaging.ConclusionsOur experience with 20 salvage pulmonary metastasectomy procedures for local recurrences following SABR in colorectal cancer patients demonstrates that salvage resection is a feasible option with acceptable morbidity and good oncological outcome in a highly selected cohort.

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Analyses of local control and survival after stereotactic body radiotherapy for pulmonary oligometastases from colorectal adenocarcinoma

Cited by 14 publications

References 18 publications

Microwave ablation of colorectal cancer lung metastases — the first experience in Poland

Microwave ablation of colorectal cancer lung metastases — the first experience in Poland

Is it time for redefining oligometastatic disease? Analysis of lung metastases CT in ten tumor types

Salvage surgery for local recurrences after stereotactic ablative radiotherapy of colorectal pulmonary metastases

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