Abstract
ObjectiveTo evaluate the safety and efficacy of cryoablation for metastatic lung tumors from colorectal cancer.MethodsThe procedures were performed on 24 patients (36–82 years of age, with a median age of 62; 17 male patients, 7 female patients) for 55 metastatic tumors in the lung, during 30 sessions. The procedural safety, local progression free interval, and overall survival were assessed by follow-up computed tomographic scanning performed every 3–4 months.ResultsThe major complications were pneumothorax, 19 sessions (63%), pleural effusion, 21 sessions (70%), transient and self-limiting hemoptysis, 13 sessions (43%) and tract seeding, 1 session (3%). The 1- and 3-year local progression free intervals were 90.8% and 59%, respectively. The 3-years local progression free intervals of tumors ≤15 mm in diameter was 79.8% and that of tumors >15 mm was 28.6% (p = 0.001; log-rank test). The 1- and 3-year overall survival rates were 91% and 59.6%, respectively.ConclusionThe results indicated that percutaneous cryoablation is a feasible treatment option. The local progression free interval was satisfactory at least for tumors that were ≤15 mm in diameter.
Highlights
Pulmonary metastases are common in patients with colorectal cancer
We have previously reported the preliminary results of percutaneous cryoablation for lung tumors performed under computed tomography (CT) guidance with local anesthesia as a local curative treatment, which showed promising perioperative outcomes and local disease control in a mixed group of tumors [16]
In order to evaluate the safety and efficacy of this procedure for pulmonary metastasis from colorectal cancer, we have retrospectively reviewed the safety, the local progression free interval, and the survival rates in 24 nonsurgical candidates in this study
Summary
Pulmonary metastases are common in patients with colorectal cancer. The 5-year probability of survival was found to be 27–40% [1,2,3,4,5,6,7] in patients who had undergone surgical resection. In 1965, Thomford et al, reported criteria for resection of metastatic lung tumors which have been generally accepted by the surgical community [8]. Resectability depends on the number and location of lesions, patient’s age, comorbidities and pulmonary function tests as well as the ECOG performance status. Nonsurgical candidates are usually managed with systemic chemotherapy. As for chemotherapy, newer systemic chemotherapeutic regimens for metastatic colorectal cancer have recently shown improved response rates (35–50%) and overall survival (18– 20months) [9,10,11]. A less invasive local therapeutic option is desirable, that is as effective as surgery
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