Percutaneous Radiofrequency Ablation of Pulmonary Metastases from Colorectal Carcinoma: Prognostic Determinants for Survival

Yan, Tristan D.; King, Julie; Sjarif, Adrian; Glenn, Derek; Steinke, Karin; Morris, David L.

doi:10.1245/s10434-006-9101-1

Cited by 137 publications

(102 citation statements)

References 29 publications

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“…Many studies have shown that tumor size is a significant prognostic factor for survival of patients treated with RF ablation. These studies indicate that there is significant difference between the survival outcomes of tumors <3 cm and >3 cm (22)(23)(24). However, tumor size was not found to be a contributory prognostic factor in our study.…”

Section: Discussioncontrasting

confidence: 58%

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Akhan¹,

Güler²,

Akıncı³

et al. 2015

Diagn Interv Radiol

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P rimary lung cancer is the leading cause of cancer-related death worldwide (1). Treatment of primary lung cancers includes surgical resection, radiation therapy, chemotherapy, and thermal ablation. Surgical resection remains the treatment of choice for patients with early stage non-small cell lung cancer (NSCLC) (2). However, primary lung cancers are generally diagnosed in advanced stages. Moreover, due to the high incidence of associated comorbidities and limited pulmonary reserve, most patients are considered ineligible for surgery (3,4).In addition to primary cancers, lungs are the second most frequent site of metastatic disease. In selected patients with metastatic lung cancer, surgical resection is the preferred treatment. However, even patients who have undergone a complete resection have a high incidence of recurrence and may require multiple surgeries (5). Repeat thoracotomy leads to further removal of functional pulmonary tissue. Surgical resection might not be possible in patients with certain comorbidities and limited pulmonary reserve.Patients with pulmonary colorectal metastases constitute a significant portion of metastatic lung tumor group. Approximately 10% of patients with colorectal cancer develop pulmonary metastases during the course of disease (6). It has been reported that in patients with limited colorectal pulmonary metastases and no extrapulmonary disease, five-year survival following surgical resection is approximately 35%-45% (7). However, many patients are not suitable candidates for surgery. PURPOSEWe aimed to evaluate the survival benefit achieved with radiofrequency (RF) ablation of primary and metastatic lung tumors and determine significant prognostic factors for recurrence-free survival. METHODSForty-nine patients with lung cancer (10 primary and 39 metastatic) underwent computed tomography-guided percutaneous RF ablation between June 2005 and October 2013. A total of 112 tumors (101 metastatic and 11 primary non-small cell lung cancer) were treated with RF ablation. Tumor diameter ranged from 0.6 to 4 cm (median 1.5 cm). Effectiveness of treatment, complications, and survival were analyzed. RESULTSPrimary success rate was 79.5% and local tumor progression occurred in 23 tumors. Among tumors showing progression, 10 were re-treated with RF ablation and secondary success rate was 87.5%. One-, two-, and three-year overall survival rates of 10 patients with primary lung cancer were 100%, 86%, and 43%, respectively. One-, two-, three-, four-, and five-year overall survival rates for 39 patients with metastatic lung tumors were 90%, 73%, 59%, 55%, and 38%, respectively. One-, two-, three-, and four-year overall survival rates for 16 patients with colorectal pulmonary metastases were 94%, 80%, 68%, and 23%, respectively. Complications occurred in 30 sessions (24.6%). Pneumothorax occurred in 19 sessions with seven requiring image-guided percutaneous chest tube drainage. Tumor status (solitary or multiple) and presence of extrapulmonary metastasis at initial RF ablation were significa...

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Section: Discussioncontrasting

confidence: 58%

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Akhan¹,

Güler²,

Akıncı³

et al. 2015

Diagn Interv Radiol

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“…Grieco [69]. Similar survival rates have been reported by different groups in colorectal lung metastases, with overall survival ranging 64-78% [14].…”

Section: Outcomes and Effectivenesssupporting

confidence: 72%

Standards of Practice: Guidelines for Thermal Ablation of Primary and Secondary Lung Tumors

Pereira

Salvatore²

2012

Cardiovasc Intervent Radiol

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“…The ideal target lesion for ablation is a lesion measuring less than 3 cm diameter, and not in contact with large vessels or bronchi, mediastinum and chest wall (2,13,(24)(25)(26)(27)(28)(29)(30).…”

Section: Indicationsmentioning

confidence: 99%

“…In case of incomplete resection, survival drops to 13 and 7% at 5 and 10 years, respectively (43). After percutaneous ablation of pulmonary metastatic lesions, the survival is 64 to 78% at 2 years and 27 to 57% at 5 years (26,29,30,41,44) (Table II). Results are significantly higher in case of combined ablation / chemotherapy than chemotherapy alone (87 versus 33%) (45).…”

Section: Pulmonary Metastasesmentioning

confidence: 99%

Percutaneous ablation of malignant thoracic tumors

Ghaye

2013

Journal of the Belgian Society of Radiology

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Lung cancer is the leading cause of death related to cancer. Fifteen to thirty percent of patients with a localized lung cancer are actually inoperable as they present with poor general condition, limited cardiopulmonary function, or a too high surgical risk. Therefore, minimally invasive treatments are needed and percutaneous ablation seems an attractive option. Thermal ablation can be performed by delivering heat (radiofrequency, microwave, laser) or cold (cryotherapy) through a needle inserted into the tumor under CT guidance. The ideal lesion is less than 2 or 3 cm in diameter. Success of percutaneous thermal ablation appears to be close to those of surgery for localized lung cancer. Nevertheless studies are still needed to definitely assess the role of ablation compared to other emerging techniques, as stereo tactic radiotherapy as well as potential synergy with other treatments.

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Percutaneous Radiofrequency Ablation of Pulmonary Metastases from Colorectal Carcinoma: Prognostic Determinants for Survival

Abstract: Percutaneous lung RFA may play a useful role in nonsurgical candidates with colorectal pulmonary metastases. However, the survival benefit of this interventional procedure for patients with a pulmonary metastasis >3 cm was limited.

Cited by 137 publications

References 29 publications

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Standards of Practice: Guidelines for Thermal Ablation of Primary and Secondary Lung Tumors

Percutaneous ablation of malignant thoracic tumors

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