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01-11-2006

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

Authors: Tristan D. Yan, BSc (Med), MBBS, Julie King, MPH, Adrian Sjarif, MBBS, Derek Glenn, FRACR, Karin Steinke, MD, David L. Morris, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2006

Abstract

Background

Preliminary results have shown that percutaneous radiofrequency ablation (RFA) may play a useful role in patients with inoperable lung tumors. This series evaluated the prognostic features for survival in nonsurgical candidates who underwent percutaneous RFA of pulmonary metastases from colorectal carcinoma.

Methods

Fifty-five patients not suitable for surgery underwent percutaneous RFA for colorectal pulmonary metastases. All clinical and treatment-related data were collected prospectively. The primary end point of the study was overall survival, defined from the time of RFA intervention. Univariate and multivariate analyses were performed to identify statistically significant prognostic parameters for overall survival.

Results

The overall median survival was 33 months (range, 4–40 months), with actuarial 1-, 2-, and 3-year survival of 85%, 64%, and 46%, respectively. Univariate analysis demonstrated that largest size of lung metastasis (P < .001), location of lung metastases (P = .032), and repeat percutaneous RFA for pulmonary recurrence (P = .024) were statistically significant for overall survival. Multivariate analysis demonstrated that largest size of lung metastasis >3 cm was independently associated with a reduced overall survival (P = .003).

Conclusions

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.

Pastorino U, McCormack PM, Ginsberg RJ, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg 1997;113:37–49CrossRef

Okumura S, Kondo H, Tsuboi M, et al. Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 1996;112:867–74CrossRefPubMed

van Halteren HK, van Geel AN, Hart AA, Zoetmulder FA. Pulmonary resection for metastases of colorectal origin. Chest 1995;107:1525–31

Brister SJ, de Varennes B, Gordon PH, Sheiner NM, Pym J. Contemporary operative management of pulmonary metastases of colorectal origin. Dis Colon Rectum 1998;31:786–92

Sakamoto T, Tsubota N, Iwanaga K, Yuki T, Matsuoka H, Yoshimura M. Pulmonary resection for metastases from colorectal cancer. Chest 2001;119:1069–72CrossRefPubMed

Morrow CE, Vassilopoulos PP, Grage TB. Surgical resection for metastatic neoplasms of the lung: experience at the University of Minnesota Hospitals. Cancer 1980;45:2981–5CrossRefPubMed

McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases: 10-year results. Arch Surg 1992;127:1403–6PubMed

Rusch VW. Pulmonary metastasectomy. Current indications. Chest 1995;107:322S–31S

Watanable I, Arai T, Ono M, et al. Prognostic factors in resection of pulmonary metastasis from colorectal cancer. Br J Surg 2003;90:1436–40CrossRef

10.

Pfannschmidt J, Muley T, Hoffmann H, Dienemann H. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experienced in 167 patients. J Thorac Cardiovasc Surg 2003;126:732–9CrossRefPubMed

11.

Saito Y, Omiya H, Kohno K, et al. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 2002;124:1007–13CrossRefPubMed

12.

Rena O, Casadio C, Viano F, et al. Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis. Twenty-year experience. Eur J Cardiothorac Surg 2002;21:906–12CrossRefPubMed

13.

Moertel CG. Chemotherapy for colorectal cancer. N Engl J Med 1994;330:1136–9CrossRefPubMed

14.

Levi F, Zidani R, Brienza S, et al. A multicenter evaluation of intensified, ambulatory, chronomodulated chemotherapy with oxaliplatin, 5-flurouracil and leucovorin as initial treatment of patients with metastatic colorectal carcinoma. International Organization for Cancer Chronotherapy. Cancer 1999;85:2532–40CrossRefPubMed

15.

Rougier P, Van Cutsem E, Bajetta E, et al. Randomized trial of irinotecan vs fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 1998;35:1407–12CrossRef

16.

de Gramont A, Figer A, Seymour M, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000;18:2938–47PubMed

17.

Douillard J-Y, Cunningham D, Roth AD, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicenter randomized trial. Lancet 2000;355:1041–7CrossRefPubMed

18.

Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 2000;18:136–47PubMed

19.

Steinke K, Glenn D, King J, et al. Percutaneous imaging–guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up. Ann Surg Oncol 2004;11:207–12CrossRefPubMed

20.

King J, Glenn D, Clark W, et al. Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer. Br J Surg 2004;91:217–23CrossRefPubMed

21.

Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 2001;221:159–66PubMed

22.

Steinke K, Sewell PE, Dupuy D, et al. Pulmonary radiofrequency ablation—an international study survey. Anticancer Res 2004;24:339–43PubMed

23.

Dupuy DE, Mayo-Smith WW, Abbott GF, DiPetrillo T. Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics 2002; 22:S259–S269

24.

Vaughn C, Mychaskiw G II, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg 2002;94:1149–51CrossRefPubMed

25.

Lee J, Jin K, Goldberg SN, et al. Percutaneous radiofrequency ablation for inoperable non–small cell lung cancer and metastases: preliminary report. Radiology 2004;230:125–34PubMed

26.

Fernando HC, Hoyos AD, Landreneau RJ, et al. Radiofrequency ablation for the treatment of non–small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 2005;129:639–44CrossRefPubMed

27.

Nishida T, Inoue K, Kawata Y, et al. Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 2002;195:426–30CrossRefPubMed

28.

Suh RD, Wallace AB, Sheehan RE, Heinze SB, Goldin JG. Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation—preliminary results. Radiology 2003;229:821–9PubMed

29.

Steinke K, Glenn D, King J, Morris DL. Percutaneous pulmonary radiofrequency ablation: difficulty achieving complete ablations in big lung lesions. Br J Radiol 2003;76:742–5CrossRefPubMed

30.

Yan TD, King J, Derek G, Karin S, Morris DL. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma—a prospective study of 70 consecutive cases. Ann Surg Oncol. DOI: 10.1245/s10434-006-9010-3

Title: Percutaneous Radiofrequency Ablation of Pulmonary Metastases from Colorectal Carcinoma: Prognostic Determinants for Survival
Authors: Tristan D. Yan, BSc (Med), MBBS
Julie King, MPH
Adrian Sjarif, MBBS
Derek Glenn, FRACR
Karin Steinke, MD
David L. Morris, MD, PhD
Publication date: 01-11-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9101-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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