Literature DB >> 29845348

Microwave Ablation in the Management of Colorectal Cancer Pulmonary Metastases.

I Kurilova1,2,3, A Gonzalez-Aguirre1, R G Beets-Tan2, J Erinjeri1, E N Petre1, M Gonen4, M Bains5, N E Kemeny6, S B Solomon1, C T Sofocleous7.   

Abstract

PURPOSE: To review outcomes following microwave ablation (MWA) of colorectal cancer pulmonary metastases and assess predictors of oncologic outcomes.
METHODS: Technical success, primary and secondary technique efficacy rates were evaluated for 50 patients with 90 colorectal cancer pulmonary metastases at immediate, 4-8 weeks post-MWA and subsequent follow-up CT and/or 18F-FDG PET/CT. Local tumor progression (LTP) rate, LTP-free survival (LTPFS), cancer-specific and overall survivals were assessed. Complications were recorded according to SIR classification.
RESULTS: Median follow-up was 25.6 months. Median tumor size was 1 cm (0.3-3.2 cm). Technical success, primary and secondary technique efficacy rates were 99, 90 and 92%, respectively. LTP rate was 10%. One-, 2- and 3-year LTPFS were: 93, 86 and 86%, respectively, with median LTPFS not reached. Median overall survival was 58.6 months, and median cancer-specific survival (CSS) was not reached. One-, 2- and 3-year overall and CSS were 94% and 98, 82 and 90%, 61 and 70%, respectively. On univariate analysis, minimal ablation margin (p < 0.001) and tumor size (p = 0.001) predicted LTPFS, with no LTP for minimal margin ≥ 5 mm and/or tumor size < 1 cm. Pleural-based metastases were associated with increased LTP risk (p = 0.002, SHR = 7.7). Pre-MWA CEA level > 10 ng/ml (p = 0.046) and ≥ 3 prior chemotherapy lines predicted decreased CSS (p = 0.02). There was no 90-day death. Major complications rate was 13%.
CONCLUSIONS: MWA with minimal ablation margin ≥ 5 mm is essential for local control of colorectal cancer pulmonary metastases. Pleural-based metastases and larger tumor size were associated with higher risk of LTP. CEA level and pre-MWA chemotherapy impacted CSS.

Entities:  

Keywords:  Colorectal cancer; Lung ablation; Microwave ablation; Pulmonary metastases; Thermal ablation

Mesh:

Substances:

Year:  2018        PMID: 29845348      PMCID: PMC6944322          DOI: 10.1007/s00270-018-2000-6

Source DB:  PubMed          Journal:  Cardiovasc Intervent Radiol        ISSN: 0174-1551            Impact factor:   2.740


  55 in total

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2.  Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: tips from preliminary experience.

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4.  Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study.

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5.  Major complications after lung microwave ablation: a single-center experience on 204 sessions.

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Review 9.  Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis.

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Review 10.  The Roles of Carcinoembryonic Antigen in Liver Metastasis and Therapeutic Approaches.

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6.  Health-Related Quality of Life in Metastatic Colorectal Cancer Patients Treated with Curative Resection and/or Local Ablative Therapy or Systemic Therapy in the Finnish RAXO-Study.

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7.  CT after Lung Microwave Ablation: Normal Findings and Evolution Patterns of Treated Lesions.

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9.  A prospective trial of CT-guided percutaneous microwave ablation for lung tumors.

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10.  18F FDG PET/MRI with hepatocyte-specific contrast agent for M staging of rectal cancer: a primary economic evaluation.

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