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Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology

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Abstract

Aim

European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network guidelines (NCCN) have recently included interventional procedures among the standard treatments for the management of colorectal cancer (CRC) oligometastatic disease (OMD). This study overviews the practice of Interventional Radiology (IR) in Italian centers.

Methods

A practice focused questionnaire on locoregional treatments of CRC-OMD was submitted to all Italian IR centers to assess practice patterns.

Results

Thirty-three IR centers completed the questionnaire. The majority reported practice was established within a tumor board (97%), which included input from hepatobiliary surgery (94%). When considering the number of percutaneous ablation and liver-directed trans-arterial therapies performed for all tumor types, 33.5% and 13.4% were performed to specifically treat CRC-OMD. Lung ablations for CRC OMD were performed in 45.5% of centers. Regarding liver ablation, The most common technology was the microwave ablation (68.1%), which was typically performed under US guidance (78%) with conscious sedation used as the most common anaesthesia method (81%). While indication for percutaneous IR treatments was heterogeneous, 51% were performed in combination with chemotherapy in unresectable OMD. Despite new ESMO and NCCN guidelines, 59% of centers did not subjectively appreciate any change in the perception of IR treatments by other specialists; however, 63%of respondents believe that IR will have a more relevant role in the CRC-OMD management in the future.

Conclusion

CRC-OMD treatment represents a relevant part of the everyday clinical practice of the IR Italian centers with promising future prospects. Heterogeneity persists in clinical indications, requiring more robust evidence to set indications and to diffuse clinical applications.

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Abbreviations

ESMO:

European Society of Medical Oncology

NCCN:

National Comprehensive Cancer Network

CRC:

Colorectal Cancer

OMD:

Oligometastatic Disease

IR:

Interventional Radiology

IRs:

Interventional Radiologists

ICIR:

Italian College of Interventional Radiology

RFA:

Radiofrequency Ablation

MWA:

Microwave ablation

CRLM:

Colorectal Liver Metastases

CEUS:

Contrast Enhanced Ultrasound

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Acknowledgements

Authors would like to thank all the centers who replied to the survey without receiving honoraria.

Author information

Authors and Affiliations

  1. Department of Oncology, University of Torino, Regione Gonzole 10, Orbassano, TO, Italy

    Marco Calandri & Andrea Veltri

  2. Radiology Unit, A.O.U. San Luigi Gonzaga Di Orbassano, Regione Gonzole 10, Orbassano, TO, Italy

    Marco Calandri, Jacopo Brino & Andrea Veltri

  3. Radiology Unit, A.O.U. Città Della Salute E Della Scienza, Presidio Molinette, Via Genova 3, Torino, TO, Italy

    Carlo Gazzera, Giulio Antonino Strazzarino & Paolo Fonio

  4. Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Cardarelli 9, Napoli, Italy

    Francesco Giurazza

  5. Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Steven Yevich

  6. Radiology Department, IRCCS Ospedale San Raffaele E Università Vita-Salute, Via Olgettina 60, Milan, Italy

    Paolo Marra

  7. Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy

    Andrea Contegiacomo

  8. Department of Interventional Radiology, Pisa University Hospital, Pisa, Italy

    Irene Bargellini

  9. Diagnostic-Therapeutic Advanced Technology Department, ASST Santi Paolo E Carlo, Via Pio II 3, 20153, Milan, Italy

    Maurizio Cariati

  10. Department of Surgical Sciences, University of Torino, Via Genova 3, Torino, Italy

    Paolo Fonio

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  1. Marco Calandri
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Correspondence to Marco Calandri.

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Calandri, M., Gazzera, C., Giurazza, F. et al. Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology. Cardiovasc Intervent Radiol 43, 1474–1483 (2020). https://doi.org/10.1007/s00270-020-02516-3

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