Long-term outcome following microwave ablation of lung metastases from colorectal cancer

PurposeTo retrospectively evaluate the safety and efficacy of percutaneous computed tomography (CT)-guided microwave ablation (MWA) in colorectal cancer (CRC) lung metastases, and to analyze prognostic factors.Materials and methodsData were collected from 31 patients with CRC lung metastases from Ma...

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Main Authors: Yue Han, Xue Yan, Weihua Zhi, Ye Liu, Fei Xu, Dong Yan
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-07-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.943715/full
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author Yue Han
Xue Yan
Weihua Zhi
Ye Liu
Fei Xu
Dong Yan
author_facet Yue Han
Xue Yan
Weihua Zhi
Ye Liu
Fei Xu
Dong Yan
author_sort Yue Han
collection DOAJ
description PurposeTo retrospectively evaluate the safety and efficacy of percutaneous computed tomography (CT)-guided microwave ablation (MWA) in colorectal cancer (CRC) lung metastases, and to analyze prognostic factors.Materials and methodsData were collected from 31 patients with CRC lung metastases from May 2013 to September 2017. They had removed the CRC, no extrapulmonary metastases, no more than three metastases in the lung, the maximum diameter of the lesions was ≤3 cm, and all the lung metastases could be completely ablated. The ablation procedures were performed using a KY-2000 microwave multifunctional therapeutic apparatus. Efficacy is assessed two to four weeks after ablation, and follow-up are performed every three months for two years. The primary outcome was overall survival (OS). The secondary outcomes were progression-free survival (PFS), and complications. Cox regression analysis was used for the evaluation of the statistical significance of factors affecting the end result of MWA therapy. The Kaplan–Meier method was used for estimation of survival rates.ResultsA total of 45 metastatic lung lesions from CRC in 31 patients were treated with CT-guided MWA procedures. The median OS was 76 months. The one, two, three, and five-year survival rates were 93.5%, 80.6%, 61.3%, and 51.6%, respectively. Multivariate analysis showed that the primary tumor from the rectum (P = 0.009) and liver metastases at the diagnosis of lung metastases (P = 0.043) were risk factors affecting OS, while PFS was a protective factor. The median PFS was 13 months. The maximum diameter of lung metastases lesions (P = 0.004) was a risk factor. The interval between pulmonary metastases and MWA (P=0.031) was the protective factor. Pneumothorax was observed in 13 out of 36 procedures. Four patients developed pneumothorax requiring drainage tube insertion. No patient deaths occurred within 30 days of ablation. Three out of 31 patients (9.67%) were found to have local recurrence of the original lung metastatic ablation foci.ConclusionMWA therapy may be safely and effectively used as a therapeutic tool for the treatment of selected CRC pulmonary metastases, and the prognosis is better in patients without liver metastases at the diagnosis of lung metastases.
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spelling doaj.art-e743fe234393476cbee3277bc9155d242022-12-22T03:04:17ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-07-011210.3389/fonc.2022.943715943715Long-term outcome following microwave ablation of lung metastases from colorectal cancerYue Han0Xue Yan1Weihua Zhi2Ye Liu3Fei Xu4Dong Yan5Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of General Surgery, Cancer Hospital of Huanxing, Beijing, ChinaDepartment of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaLondon School of Hygiene and Tropical Medicine, University of London, London, United KingdomDepartment of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPurposeTo retrospectively evaluate the safety and efficacy of percutaneous computed tomography (CT)-guided microwave ablation (MWA) in colorectal cancer (CRC) lung metastases, and to analyze prognostic factors.Materials and methodsData were collected from 31 patients with CRC lung metastases from May 2013 to September 2017. They had removed the CRC, no extrapulmonary metastases, no more than three metastases in the lung, the maximum diameter of the lesions was ≤3 cm, and all the lung metastases could be completely ablated. The ablation procedures were performed using a KY-2000 microwave multifunctional therapeutic apparatus. Efficacy is assessed two to four weeks after ablation, and follow-up are performed every three months for two years. The primary outcome was overall survival (OS). The secondary outcomes were progression-free survival (PFS), and complications. Cox regression analysis was used for the evaluation of the statistical significance of factors affecting the end result of MWA therapy. The Kaplan–Meier method was used for estimation of survival rates.ResultsA total of 45 metastatic lung lesions from CRC in 31 patients were treated with CT-guided MWA procedures. The median OS was 76 months. The one, two, three, and five-year survival rates were 93.5%, 80.6%, 61.3%, and 51.6%, respectively. Multivariate analysis showed that the primary tumor from the rectum (P = 0.009) and liver metastases at the diagnosis of lung metastases (P = 0.043) were risk factors affecting OS, while PFS was a protective factor. The median PFS was 13 months. The maximum diameter of lung metastases lesions (P = 0.004) was a risk factor. The interval between pulmonary metastases and MWA (P=0.031) was the protective factor. Pneumothorax was observed in 13 out of 36 procedures. Four patients developed pneumothorax requiring drainage tube insertion. No patient deaths occurred within 30 days of ablation. Three out of 31 patients (9.67%) were found to have local recurrence of the original lung metastatic ablation foci.ConclusionMWA therapy may be safely and effectively used as a therapeutic tool for the treatment of selected CRC pulmonary metastases, and the prognosis is better in patients without liver metastases at the diagnosis of lung metastases.https://www.frontiersin.org/articles/10.3389/fonc.2022.943715/fulllung metastasescolon cancerrectal cancermicrowave ablationprognosis
spellingShingle Yue Han
Xue Yan
Weihua Zhi
Ye Liu
Fei Xu
Dong Yan
Long-term outcome following microwave ablation of lung metastases from colorectal cancer
Frontiers in Oncology
lung metastases
colon cancer
rectal cancer
microwave ablation
prognosis
title Long-term outcome following microwave ablation of lung metastases from colorectal cancer
title_full Long-term outcome following microwave ablation of lung metastases from colorectal cancer
title_fullStr Long-term outcome following microwave ablation of lung metastases from colorectal cancer
title_full_unstemmed Long-term outcome following microwave ablation of lung metastases from colorectal cancer
title_short Long-term outcome following microwave ablation of lung metastases from colorectal cancer
title_sort long term outcome following microwave ablation of lung metastases from colorectal cancer
topic lung metastases
colon cancer
rectal cancer
microwave ablation
prognosis
url https://www.frontiersin.org/articles/10.3389/fonc.2022.943715/full
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