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CardioVascular and Interventional Radiology

, Volume 41, Issue 11, pp 1727–1734 | Cite as

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

  • Mariane Fonck
  • Jean-Thomas Perez
  • Vittorio Catena
  • Yves Becouarn
  • Laurent Cany
  • Eric Brudieux
  • Laure Vayre
  • Patrick Texereau
  • Valérie Le Brun-Ly
  • Véronique Verger
  • Véronique Brouste
  • Dominique Bechade
  • Xavier Buy
  • Jean Palussière
Clinical Investigation
  • 128 Downloads

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.

Keywords

Lung metastases Colorectal cancer Radiofrequency ablation Thermal ablation 

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

Notes

Acknowledgements

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

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Mariane Fonck
    • 1
  • Jean-Thomas Perez
    • 2
  • Vittorio Catena
    • 2
  • Yves Becouarn
    • 1
  • Laurent Cany
    • 3
  • Eric Brudieux
    • 4
  • Laure Vayre
    • 5
  • Patrick Texereau
    • 6
  • Valérie Le Brun-Ly
    • 7
  • Véronique Verger
    • 8
  • Véronique Brouste
    • 9
  • Dominique Bechade
    • 1
  • Xavier Buy
    • 2
  • Jean Palussière
    • 2
  1. 1.Department of Medical OncologyInstitut BergoniéBordeauxFrance
  2. 2.Department of Interventional RadiologyInstitut BergoniéBordeauxFrance
  3. 3.Department of OncologyClinique FranchevillePérigueuxFrance
  4. 4.Department of OncologyCH Pôle de Santé du VilleneuvoisVilleneuve-Sur-LotFrance
  5. 5.Department of OncologyCH Brive Bd Docteur VerlhacBrive-La-GaillardeFrance
  6. 6.Department of OncologyCentre HospitalierMont-De-MarsanFrance
  7. 7.Department of OncologyCHU LimogesLimogesFrance
  8. 8.Department of OncologyCHI du pays de CognacCognacFrance
  9. 9.Department of Clinical and Epidemiological ResearchInstitut BergoniéBordeauxFrance

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