Microwave ablation in the management of colorectal cancer pulmonary metastases Journal Article
| Authors: | Kurilova, I.; Gonzalez-Aguirre, A.; Beets-Tan, R. G.; Erinjeri, J.; Petre, E. N.; Gonen, M.; Bains, M.; Kemeny, N. E.; Solomon, S. B.; Sofocleous, C. T. |
| Article Title: | Microwave ablation in the management of colorectal cancer pulmonary metastases |
| 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. © 2018, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). |
| Keywords: | colorectal cancer; microwave ablation; thermal ablation; pulmonary metastases; lung ablation |
| Journal Title: | CardioVascular and Interventional Radiology |
| Volume: | 41 |
| Issue: | 10 |
| ISSN: | 0174-1551 |
| Publisher: | Springer |
| Date Published: | 2018-10-01 |
| Start Page: | 1530 |
| End Page: | 1544 |
| Language: | English |
| DOI: | 10.1007/s00270-018-2000-6 |
| PROVIDER: | scopus |
| PUBMED: | 29845348 |
| PMCID: | PMC6944322 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 October 2018 -- Source: Scopus |
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