Three-year Survival Rate after Radiofrequency Ablation for Surgically Resectable Colorectal Lung Metastases: A Prospective Multicenter Study

Abstract

VASCULAR AND INTERVENTIONAL RADIOLOGYC olorectal cancer (CRC) is one of the most common malignancies in the world, with metastases to the lungs in approximately 10%-20% of patients (1). Surgery is performed when both the primary tumor and the lung metastases are completely resectable, with a 3-year overall survival (OS) rate of 53%-82% after lung metastasectomy (2-6). Systemic chemotherapy is administered for patients who are not candidates for surgery, but its 3-year OS rate is less than 50% (7,8). Stereotactic radiation therapy is another treatment option for CRC lung metastases but is usually performed in patients who are not candidates for surgery, with a reported 3-year OS rate of 43%-51% (9,10).Radiofrequency ablation (RFA) is another minimally invasive local-regional treatment for malignant lung neoplasms. It has been considered a reasonable alternative to stereotactic radiation therapy, with the advantages of requiring only one treatment procedure, with less cost, and the feasibility of repeat RFA for residual or recurrent tumor (11). The OS rate of RFA for the treatment of CRC lung metastases in patients who are not candidates for surgery is similar to that of stereotactic radiation therapy. In fact, the 3-year OS rates after RFA for colorectal pulmonary metastasis are 46%-57% in prospective studies (12,13) and 46%-76% in retrospective studies (14-16). From Results: Seventy participants with CRC (mean age, 66 years 6 10; 49 men) were evaluated. The 3-year OS rate was 84% (59 of 70 participants; 95% confidence interval [CI]: 76%, 93%). In multivariable analysis, factors associated with worse OS included rectal rather than colon location (hazard ratio [

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

“…In the most important (prospective and multicenter) and recently published study on this subject, Hasegawa et al reported a series of 70 patients with lung metastases from colorectal cancer of < 3 cm treated with RFA an OS rate at 3 years of 84%, with hardly any complications (1% of severe complications). Factors associated with a worse OS include a rectal rather than a colon origin and the absence of chemotherapy [93]. Unlike NSCLC, several published studies have evaluated the value of MWA in OLD.…”

Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

“…The first pulmonary RFA procedure was described in 2000 [5], and multiple studies have shown low rates of complications [6][7][8]. Local tumor control is comparable to wedge resection or stereotactic body radiation therapy for metastasis [9,10]. Recent guidelines for colorectal cancer metastases clearly indicate that ablation is recommended as a free-standing therapy or in combination with resection, whereas stereotactic body radiation therapy is indicated only for selected patients not amenable to resection or within a clinical trial [11].…”

Clinical Outcomes and Techniques for Radiofrequency Ablation of Lung Tumors Smaller than 1 cm

“…The application of radiofrequency ablation (RFA) for the treatment of malignant lung tumors is increasing [1][2][3][4][5]. Several studies have detected risk factors for local tumor progression after lung RFA, including tumor size, histology, and contact with major vessels [2][3][4], with large tumor size as the factor mentioned most frequently.…”