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CardioVascular and Interventional Radiology

, Volume 36, Issue 3, pp 724–730 | Cite as

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

  • Alice Gillams
  • Zahid Khan
  • Peter Osborn
  • William Lees
Clinical Investigation

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.

Keywords

Colorectal lung metastases Lung tumor ablation Pulmonary ablation Radiofrequency ablation Thermal ablation 

Notes

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.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Alice Gillams
    • 1
  • Zahid Khan
    • 2
  • Peter Osborn
    • 3
  • William Lees
    • 4
  1. 1.Radiology DepartmentThe London ClinicLondonUK
  2. 2.Countess of Chester HospitalChesterUK
  3. 3.Queen Alexandra HospitalCosham, PortsmouthUK
  4. 4.University College London Medical SchoolLondon, Greater LondonUK

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