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Pulmonary Thermal Ablation Enables Long Chemotherapy-Free Survival in Metastatic Colorectal Cancer Patients

  • Clinical Investigation
  • Published:
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Abstract

Background

Chemotherapy (ct) is the preferred treatment option in metastatic colorectal cancer (mCRC). The objective of the study was to determine the overall survival (OS), disease-free survival (DFS) and ct-free survival (CFS) of pulmonary thermal ablation (TA) and its place in the treatment of mCRC.

Patients and methods

All consecutive patients treated (over 11 years) with percutaneous TA for lung metastasis of colorectal origin were reviewed. All sequences of treatments were considered. We determined the OS, DFS and CFS of pulmonary TA.

Results

Two hundred and nine patients underwent 323 TA procedures for 630 lung metastases. Majority of the metastases (71.5%) were unilateral with a median diameter of 10 mm (2–46). A single metastasis was treated in 95 patients (45.5%), and 2–8 in 114 patients (54.5%). One hundred and thirty-two patients (63.2%) had only a single procedure, 77 patients (36.8%) had 2–5 procedures. Following the first TA (n = 209), 125 patients (59.8%) resumed ct. Sixty-four out of the 126 patients presenting lung progression were treated again with TA. The median CFS was 12.2 months (95% CI: 10.3–17.7). Patients with no extra-pulmonary metastases showed a statistically better CFS than those who had extra-pulmonary metastases with a median of 20.9 and 9.2 months, respectively (p < 0.001). Median follow-up and OS were 50 and 67.6 months, respectively.

Conclusion

This study demonstrates, for the first time, that TA enables a CFS of 12.2 months that extended to 20.9 months in patients who presented with lung-only metastases. TA is a viable option for a pause in the therapy of mCRCs.

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Abbreviations

CFS:

Chemotherapy-free survival

CI:

Confidence interval

CT:

Chemotherapy

CT:

Computed tomography

DFS:

Disease-free survival

mCRC:

Metastatic colorectal cancer

OS:

Overall survival

PET-CT:

Positron emission tomography-computed tomography

RFA:

Radiofrequency ablation

QoL:

Quality of life

TA:

Thermal ablation

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Acknowledgements

The authors would like to thank Dr. Ravi Nookala of Institut Bergonié for the medical writing service.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Institut Bergonié, 229 Cours de L’Argonne, 33000, Bordeaux, France

    Mariane Fonck, Yves Becouarn & Dominique Bechade

  2. Department of Interventional Radiology, Institut Bergonié, 229 Cours de L’Argonne, 33000, Bordeaux, France

    Jean-Thomas Perez, Vittorio Catena, Xavier Buy & Jean Palussière

  3. Department of Oncology, Clinique Francheville, 38 Boulevard de Vésone, 24000, Périgueux, France

    Laurent Cany

  4. Department of Oncology, CH Pôle de Santé du Villeneuvois, Brignol Romas, 47305, Villeneuve-Sur-Lot, France

    Eric Brudieux

  5. Department of Oncology, CH Brive Bd Docteur Verlhac, 19100, Brive-La-Gaillarde, France

    Laure Vayre

  6. Department of Oncology, Centre Hospitalier, Avenue Pierre de Coubertin BP 417, 40024, Mont-De-Marsan, France

    Patrick Texereau

  7. Department of Oncology, CHU Limoges, 2 Avenue Martin Luther King, 87042, Limoges, France

    Valérie Le Brun-Ly

  8. Department of Oncology, CHI du pays de Cognac, 65 avenue d’Angoulême, 16112, Cognac, France

    Véronique Verger

  9. Department of Clinical and Epidemiological Research, Institut Bergonié, 229 Cours de l’Argonne, 33000, Bordeaux, France

    Véronique Brouste

Authors
  1. Mariane Fonck
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  2. Jean-Thomas Perez
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  3. Vittorio Catena
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  4. Yves Becouarn
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  5. Laurent Cany
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  7. Laure Vayre
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  8. Patrick Texereau
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  9. Valérie Le Brun-Ly
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  10. Véronique Verger
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  11. Véronique Brouste
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  12. Dominique Bechade
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  13. Xavier Buy
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  14. Jean Palussière
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Corresponding author

Correspondence to Jean Palussière.

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Fonck, M., Perez, JT., Catena, V. et al. Pulmonary Thermal Ablation Enables Long Chemotherapy-Free Survival in Metastatic Colorectal Cancer Patients. Cardiovasc Intervent Radiol 41, 1727–1734 (2018). https://doi.org/10.1007/s00270-018-1939-7

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  • DOI: https://doi.org/10.1007/s00270-018-1939-7

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