Skip to main content

Advertisement

SpringerLink
Log in

Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the factors associated with favorable survival in patients with inoperable colorectal lung metastases treated with percutaneous image-guided radiofrequency ablation.

Methods

Between 2002 and 2011, a total of 398 metastases were ablated in 122 patients (87 male, median age 68 years, range 29–90 years) at 256 procedures. Percutaneous CT-guided cool-tip radiofrequency ablation was performed under sedation/general anesthesia. Maximum tumor size, number of tumors ablated, number of procedures, concurrent/prior liver ablation, previous liver or lung resection, systemic chemotherapy, disease-free interval from primary resection to lung metastasis, and survival from first ablation were recorded prospectively. Kaplan–Meier analysis was performed, and factors were compared by log rank test.

Results

The initial number of metastases ablated was 2.3 (range 1–8); the total number was 3.3 (range 1–15). The maximum tumor diameter was 1.7 (range 0.5–4) cm, and the number of procedures was 2 (range 1–10). The major complication rate was 3.9 %. Overall median and 3-year survival rate were 41 months and 57 %. Survival was better in patients with smaller tumors—a median of 51 months, with 3-year survival of 64 % for tumors 2 cm or smaller versus 31 months and 44 % for tumors 2.1–4 cm (p = 0.08). The number of metastases ablated and whether the tumors were unilateral or bilateral did not affect survival. The presence of treated liver metastases, systemic chemotherapy, or prior lung resection did not affect survival.

Conclusion

Three-year survival of 57 % in patients with inoperable colorectal lung metastases is better than would be expected with chemotherapy alone. Patients with inoperable but small-volume colorectal lung metastases should be referred for ablation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84:324–338

    Article  PubMed  Google Scholar 

  2. Kaifi JT, Gusani NJ, Deshaies I et al (2010) Indications and approach to surgical resection of lung metastases. J Surg Oncol 102:187–195

    Article  PubMed  Google Scholar 

  3. Gillams AR, Lees WR (2008) Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 18:672–677

    Article  PubMed  Google Scholar 

  4. Hiraki T, Gobara H, Mimura H et al (2011) Radiofrequency ablation of lung cancer at Okayama University Hospital: a review of 10 years of experience. Acta Med Okayama 65:287–297

    PubMed  Google Scholar 

  5. Simon CJ, Dupuy DE, DiPetrillo TA et al (2007) Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 243:268–275

    Article  PubMed  Google Scholar 

  6. Lencioni R, Crocetti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 9:621–628

    Article  PubMed  Google Scholar 

  7. Yan TD, King J, Sjarif A et al (2006) Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol 13:1529–1537

    Article  PubMed  Google Scholar 

  8. Yamakado K, Hase S, Matsuoka T et al (2012) Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicentre study in Japan. J Vasc Interv Radiol 18:393–398

    Article  Google Scholar 

  9. Anderson EM, Lees WR, Gillams AR (2009) Early indicators of treatment success after percutaneous radiofrequency of pulmonary tumors. Cardiovasc Intervent Radiol 32:478–483

    Article  PubMed  Google Scholar 

  10. Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739

    Article  PubMed  Google Scholar 

  11. Gadaleta C, Mattioli V, Colucci G et al (2004) Radiofrequency ablation of 40 lung neoplasms: preliminary results. AJR Am J Roentgenol 183:361–368

    Article  PubMed  Google Scholar 

  12. de Baere T, Palussiere J, Auperin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 240:587–596

    Article  PubMed  Google Scholar 

  13. Jarabo JR, Fernandez E, Calatayud J et al (2011) More than one pulmonary resections or combined lung-liver resection in 79 patients with metastatic colorectal carcinoma. J Surg Oncol 104:781–786

    Article  PubMed  Google Scholar 

  14. Kelekis AD, Thanos L, Mylona S et al (2006) Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: current status. Eur Radiol 16:2471–2482

    Article  PubMed  CAS  Google Scholar 

  15. Palussiere J, Gomez F, Cannella M et al (2012) Single-session radiofrequency ablation of bilateral lung metastases. Cardiovasc Intervent Radiol 35:852–859

    Article  PubMed  Google Scholar 

  16. Solomon SB, Thornton RH, Dupuy DE et al (2008) Protection of the mediastinum and chest wall with an artificial pneumothorax during lung ablations. J Vasc Interv Radiol 19:610–615

    Article  PubMed  Google Scholar 

  17. Hiraki T, Sakurai J, Tsuda T et al (2006) Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Cancer 107:2873–2880

    Article  PubMed  Google Scholar 

  18. Okuma T, Matsuoka T, Yamamoto A et al (2010) Determinants of local progression after computed tomography-guided percutaneous radiofrequency ablation for unresectable lung tumors: 9-year experience in a single institution. Cardiovasc Intervent Radiol 33:787–793

    Article  PubMed  Google Scholar 

  19. Pereira PL, Salvatore M (2012) Standards of practice: guidelines for thermal ablation of primary and secondary lung tumors. Cardiovasc Intervent Radiol 35:247–254

    Article  PubMed  Google Scholar 

  20. Saito Y, Omiya H, Kohno K et al (2002) Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 124:1007–1013

    Article  PubMed  Google Scholar 

  21. Garcia-Yuste M, Cassivi S, Paleru C (2010) The number of pulmonary metastases: influence on practice and outcome. J Thorac Oncol 5:S161–S163

    Article  PubMed  Google Scholar 

  22. Borasio P, Gisabella M, Bille A et al (2011) Role of surgical resection in colorectal lung metastases: analysis of 137 patients. Int J Colorectal Dis 26:183–190

    Article  PubMed  Google Scholar 

  23. Pereszlenyi A, Rolle A, Koch R et al (2005) Resection of multiple lung metastases—where are the limits? Bratisl Lek Listy 106:262–265

    PubMed  CAS  Google Scholar 

  24. Inoue M, Ohta M, Iuchi K et al (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78:238–244

    Article  PubMed  Google Scholar 

  25. Adam R, Avisar E, Ariche A et al (2001) Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol 8:347–353

    Article  PubMed  CAS  Google Scholar 

  26. Norihisa Y, Nagata Y, Takayama K et al (2008) Stereotactic body radiotherapy for oligometastatic lung tumors. Int J Radiat Oncol Biol Phys 72:398–403

    Article  PubMed  Google Scholar 

  27. Ricardi U, Filippi AR, Guarneri A et al (2012) Stereotactic body radiation therapy for lung metastases. Lung Cancer 75:77–81

    Article  PubMed  Google Scholar 

  28. Kim MS, Yoo SY, Cho CK et al (2009) Stereotactic body radiation therapy using three fractions for isolated lung recurrence from colorectal cancer. Oncology 76:212–219

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

A. R. Gillams has received equipment and speaker fees from Covidien. The other authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Radiology Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, UK

    Alice Gillams

  2. Countess of Chester Hospital, Liverpool Road, Chester, CH2 1UL, UK

    Zahid Khan

  3. Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY, UK

    Peter Osborn

  4. University College London Medical School, 235 Euston Road, London, Greater London, NW1 2BU, UK

    William Lees

Authors
  1. Alice Gillams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zahid Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Osborn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William Lees
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alice Gillams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gillams, A., Khan, Z., Osborn, P. et al. Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases. Cardiovasc Intervent Radiol 36, 724–730 (2013). https://doi.org/10.1007/s00270-012-0500-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-012-0500-3

Keywords

Search

Navigation