Microwave Ablation of Colorectal Pulmonary Metastases Offers Excellent Local Tumor Control and Can Prolong Time Off Chemotherapy Journal Article
| Authors: | Cooke, T. M.; Sofocleous, C. T.; Petre, E. N.; Alexander, E. S.; Ziv, E.; Solomon, S. B.; Sotirchos, V. S. |
| Article Title: | Microwave Ablation of Colorectal Pulmonary Metastases Offers Excellent Local Tumor Control and Can Prolong Time Off Chemotherapy |
| Abstract: | Purpose: To evaluate oncologic outcomes after microwave ablation (MWA) of colorectal pulmonary metastases, with focus on disease control without chemotherapy. Materials and methods: This institutional review board-approved retrospective study examined patients with oligometastatic or oligoprogressive colorectal pulmonary metastases undergoing MWA between January 2011 and December 2021. Imaging response was assessed with CT at 4–8 weeks post-MWA, with subsequent cross-sectional follow-up imaging every 2–4 months. Local tumor progression-free survival (LTPFS), chemotherapy-free survival (CFS) and overall survival (OS) were calculated using Kaplan–Meier methodology. Variables were evaluated for predictive significance using the log-rank test and Cox regression. Results: Two hundred twenty-five patients (127 male, 98 female; median age: 55 years) with 720 pulmonary metastases underwent 400 MWA sessions (mean number of treated metastases per session: 1.8; range 1–9). Mean treated tumor size was 0.9 cm. LTPFS at 1, 2 and 3-years was 91.9%, 85.9% and 81.5%, respectively. Tumors ≥ 1 cm in size, pleural-based tumors and pre-MWA carcinoembryonic antigen (CEA) levels ≥ 10 ng/mL were associated with shorter LTPFS (all P < 0.001). 74.7% (168/225) of patients did not receive chemotherapy for at least two months after the initial MWA. Median CFS was 12 months (95% CI 7.8–16.2) and was significantly prolonged in patients with lung-only disease compared to those with concurrent extrapulmonary disease (34.4 vs. 4.0 months, P < 0.001). Median OS was 47 months (95% CI 36.7–57.3). Conclusion: MWA of colorectal pulmonary metastases is associated with high local tumor control rates and can offer prolonged CFS, particularly for patients without concurrent extrapulmonary disease. © Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2025. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; human tissue; treatment response; overall survival; fluorouracil; cancer patient; cancer staging; nuclear magnetic resonance imaging; outcome assessment; follow up; colorectal cancer; metastasis; progression free survival; computer assisted tomography; tumor volume; irinotecan; liver metastasis; lung metastasis; hospitalization; pleura effusion; tumor growth; cancer control; oxaliplatin; radiofrequency ablation; stereotactic body radiation therapy; lung nodule; microwave radiation; non small cell lung cancer; microwave ablation; local tumor progression; human; male; female; article; positron emission tomography-computed tomography; lung ablation; microwave thermotherapy; oligometastatic disease; chemotherapy-free survival; colorectal pulmonary metastasis |
| Journal Title: | CardioVascular and Interventional Radiology |
| Volume: | 48 |
| Issue: | 6 |
| ISSN: | 01741551 |
| Publisher: | Springer Science+business Media, Llc, Part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (cirse) 2025 |
| Date Published: | 2025-01-01 |
| Start Page: | 769 |
| End Page: | 776 |
| Language: | English |
| DOI: | 10.1007/s00270-025-04036-4 |
| PUBMED: | 40295397 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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