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Erschienen in: Annals of Surgical Oncology 11/2006

01.11.2006

Percutaneous Radiofrequency Ablation of Pulmonary Metastases from Colorectal Carcinoma: Prognostic Determinants for Survival

verfasst von: Tristan D. Yan, BSc (Med), MBBS, Julie King, MPH, Adrian Sjarif, MBBS, Derek Glenn, FRACR, Karin Steinke, MD, David L. Morris, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 11/2006

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Abstract

Background

Preliminary results have shown that percutaneous radiofrequency ablation (RFA) may play a useful role in patients with inoperable lung tumors. This series evaluated the prognostic features for survival in nonsurgical candidates who underwent percutaneous RFA of pulmonary metastases from colorectal carcinoma.

Methods

Fifty-five patients not suitable for surgery underwent percutaneous RFA for colorectal pulmonary metastases. All clinical and treatment-related data were collected prospectively. The primary end point of the study was overall survival, defined from the time of RFA intervention. Univariate and multivariate analyses were performed to identify statistically significant prognostic parameters for overall survival.

Results

The overall median survival was 33 months (range, 4–40 months), with actuarial 1-, 2-, and 3-year survival of 85%, 64%, and 46%, respectively. Univariate analysis demonstrated that largest size of lung metastasis (P < .001), location of lung metastases (P = .032), and repeat percutaneous RFA for pulmonary recurrence (P = .024) were statistically significant for overall survival. Multivariate analysis demonstrated that largest size of lung metastasis >3 cm was independently associated with a reduced overall survival (P = .003).

Conclusions

Percutaneous lung RFA may play a useful role in nonsurgical candidates with colorectal pulmonary metastases. However, the survival benefit of this interventional procedure for patients with a pulmonary metastasis >3 cm was limited.
Literatur
1.
Zurück zum Zitat Pastorino U, McCormack PM, Ginsberg RJ, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg 1997;113:37–49CrossRef Pastorino U, McCormack PM, Ginsberg RJ, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg 1997;113:37–49CrossRef
2.
Zurück zum Zitat Okumura S, Kondo H, Tsuboi M, et al. Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 1996;112:867–74CrossRefPubMed Okumura S, Kondo H, Tsuboi M, et al. Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 1996;112:867–74CrossRefPubMed
3.
Zurück zum Zitat van Halteren HK, van Geel AN, Hart AA, Zoetmulder FA. Pulmonary resection for metastases of colorectal origin. Chest 1995;107:1525–31 van Halteren HK, van Geel AN, Hart AA, Zoetmulder FA. Pulmonary resection for metastases of colorectal origin. Chest 1995;107:1525–31
4.
Zurück zum Zitat Brister SJ, de Varennes B, Gordon PH, Sheiner NM, Pym J. Contemporary operative management of pulmonary metastases of colorectal origin. Dis Colon Rectum 1998;31:786–92 Brister SJ, de Varennes B, Gordon PH, Sheiner NM, Pym J. Contemporary operative management of pulmonary metastases of colorectal origin. Dis Colon Rectum 1998;31:786–92
5.
Zurück zum Zitat Sakamoto T, Tsubota N, Iwanaga K, Yuki T, Matsuoka H, Yoshimura M. Pulmonary resection for metastases from colorectal cancer. Chest 2001;119:1069–72CrossRefPubMed Sakamoto T, Tsubota N, Iwanaga K, Yuki T, Matsuoka H, Yoshimura M. Pulmonary resection for metastases from colorectal cancer. Chest 2001;119:1069–72CrossRefPubMed
6.
Zurück zum Zitat Morrow CE, Vassilopoulos PP, Grage TB. Surgical resection for metastatic neoplasms of the lung: experience at the University of Minnesota Hospitals. Cancer 1980;45:2981–5CrossRefPubMed Morrow CE, Vassilopoulos PP, Grage TB. Surgical resection for metastatic neoplasms of the lung: experience at the University of Minnesota Hospitals. Cancer 1980;45:2981–5CrossRefPubMed
7.
Zurück zum Zitat McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases: 10-year results. Arch Surg 1992;127:1403–6PubMed McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases: 10-year results. Arch Surg 1992;127:1403–6PubMed
8.
Zurück zum Zitat Rusch VW. Pulmonary metastasectomy. Current indications. Chest 1995;107:322S–31S Rusch VW. Pulmonary metastasectomy. Current indications. Chest 1995;107:322S–31S
9.
Zurück zum Zitat Watanable I, Arai T, Ono M, et al. Prognostic factors in resection of pulmonary metastasis from colorectal cancer. Br J Surg 2003;90:1436–40CrossRef Watanable I, Arai T, Ono M, et al. Prognostic factors in resection of pulmonary metastasis from colorectal cancer. Br J Surg 2003;90:1436–40CrossRef
10.
Zurück zum Zitat Pfannschmidt J, Muley T, Hoffmann H, Dienemann H. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experienced in 167 patients. J Thorac Cardiovasc Surg 2003;126:732–9CrossRefPubMed Pfannschmidt J, Muley T, Hoffmann H, Dienemann H. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experienced in 167 patients. J Thorac Cardiovasc Surg 2003;126:732–9CrossRefPubMed
11.
Zurück zum Zitat Saito Y, Omiya H, Kohno K, et al. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 2002;124:1007–13CrossRefPubMed Saito Y, Omiya H, Kohno K, et al. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 2002;124:1007–13CrossRefPubMed
12.
Zurück zum Zitat Rena O, Casadio C, Viano F, et al. Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis. Twenty-year experience. Eur J Cardiothorac Surg 2002;21:906–12CrossRefPubMed Rena O, Casadio C, Viano F, et al. Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis. Twenty-year experience. Eur J Cardiothorac Surg 2002;21:906–12CrossRefPubMed
14.
Zurück zum Zitat Levi F, Zidani R, Brienza S, et al. A multicenter evaluation of intensified, ambulatory, chronomodulated chemotherapy with oxaliplatin, 5-flurouracil and leucovorin as initial treatment of patients with metastatic colorectal carcinoma. International Organization for Cancer Chronotherapy. Cancer 1999;85:2532–40CrossRefPubMed Levi F, Zidani R, Brienza S, et al. A multicenter evaluation of intensified, ambulatory, chronomodulated chemotherapy with oxaliplatin, 5-flurouracil and leucovorin as initial treatment of patients with metastatic colorectal carcinoma. International Organization for Cancer Chronotherapy. Cancer 1999;85:2532–40CrossRefPubMed
15.
Zurück zum Zitat Rougier P, Van Cutsem E, Bajetta E, et al. Randomized trial of irinotecan vs fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 1998;35:1407–12CrossRef Rougier P, Van Cutsem E, Bajetta E, et al. Randomized trial of irinotecan vs fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet 1998;35:1407–12CrossRef
16.
Zurück zum Zitat de Gramont A, Figer A, Seymour M, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000;18:2938–47PubMed de Gramont A, Figer A, Seymour M, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000;18:2938–47PubMed
17.
Zurück zum Zitat Douillard J-Y, Cunningham D, Roth AD, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicenter randomized trial. Lancet 2000;355:1041–7CrossRefPubMed Douillard J-Y, Cunningham D, Roth AD, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicenter randomized trial. Lancet 2000;355:1041–7CrossRefPubMed
18.
Zurück zum Zitat Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 2000;18:136–47PubMed Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 2000;18:136–47PubMed
19.
Zurück zum Zitat Steinke K, Glenn D, King J, et al. Percutaneous imaging–guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up. Ann Surg Oncol 2004;11:207–12CrossRefPubMed Steinke K, Glenn D, King J, et al. Percutaneous imaging–guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up. Ann Surg Oncol 2004;11:207–12CrossRefPubMed
20.
Zurück zum Zitat King J, Glenn D, Clark W, et al. Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer. Br J Surg 2004;91:217–23CrossRefPubMed King J, Glenn D, Clark W, et al. Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer. Br J Surg 2004;91:217–23CrossRefPubMed
21.
Zurück zum Zitat Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 2001;221:159–66PubMed Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 2001;221:159–66PubMed
22.
Zurück zum Zitat Steinke K, Sewell PE, Dupuy D, et al. Pulmonary radiofrequency ablation—an international study survey. Anticancer Res 2004;24:339–43PubMed Steinke K, Sewell PE, Dupuy D, et al. Pulmonary radiofrequency ablation—an international study survey. Anticancer Res 2004;24:339–43PubMed
23.
Zurück zum Zitat Dupuy DE, Mayo-Smith WW, Abbott GF, DiPetrillo T. Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics 2002; 22:S259–S269 Dupuy DE, Mayo-Smith WW, Abbott GF, DiPetrillo T. Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics 2002; 22:S259–S269
24.
Zurück zum Zitat Vaughn C, Mychaskiw G II, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg 2002;94:1149–51CrossRefPubMed Vaughn C, Mychaskiw G II, Sewell P. Massive hemorrhage during radiofrequency ablation of a pulmonary neoplasm. Anesth Analg 2002;94:1149–51CrossRefPubMed
25.
Zurück zum Zitat Lee J, Jin K, Goldberg SN, et al. Percutaneous radiofrequency ablation for inoperable non–small cell lung cancer and metastases: preliminary report. Radiology 2004;230:125–34PubMed Lee J, Jin K, Goldberg SN, et al. Percutaneous radiofrequency ablation for inoperable non–small cell lung cancer and metastases: preliminary report. Radiology 2004;230:125–34PubMed
26.
Zurück zum Zitat Fernando HC, Hoyos AD, Landreneau RJ, et al. Radiofrequency ablation for the treatment of non–small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 2005;129:639–44CrossRefPubMed Fernando HC, Hoyos AD, Landreneau RJ, et al. Radiofrequency ablation for the treatment of non–small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 2005;129:639–44CrossRefPubMed
27.
Zurück zum Zitat Nishida T, Inoue K, Kawata Y, et al. Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 2002;195:426–30CrossRefPubMed Nishida T, Inoue K, Kawata Y, et al. Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 2002;195:426–30CrossRefPubMed
28.
Zurück zum Zitat Suh RD, Wallace AB, Sheehan RE, Heinze SB, Goldin JG. Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation—preliminary results. Radiology 2003;229:821–9PubMed Suh RD, Wallace AB, Sheehan RE, Heinze SB, Goldin JG. Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation—preliminary results. Radiology 2003;229:821–9PubMed
29.
Zurück zum Zitat Steinke K, Glenn D, King J, Morris DL. Percutaneous pulmonary radiofrequency ablation: difficulty achieving complete ablations in big lung lesions. Br J Radiol 2003;76:742–5CrossRefPubMed Steinke K, Glenn D, King J, Morris DL. Percutaneous pulmonary radiofrequency ablation: difficulty achieving complete ablations in big lung lesions. Br J Radiol 2003;76:742–5CrossRefPubMed
30.
Zurück zum Zitat Yan TD, King J, Derek G, Karin S, Morris DL. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma—a prospective study of 70 consecutive cases. Ann Surg Oncol. DOI: 10.1245/s10434-006-9010-3 Yan TD, King J, Derek G, Karin S, Morris DL. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma—a prospective study of 70 consecutive cases. Ann Surg Oncol. DOI: 10.1245/s10434-006-9010-3
Metadaten
Titel
Percutaneous Radiofrequency Ablation of Pulmonary Metastases from Colorectal Carcinoma: Prognostic Determinants for Survival
verfasst von
Tristan D. Yan, BSc (Med), MBBS
Julie King, MPH
Adrian Sjarif, MBBS
Derek Glenn, FRACR
Karin Steinke, MD
David L. Morris, MD, PhD
Publikationsdatum
01.11.2006
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 11/2006
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9101-1

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