Long-Term Outcomes in Percutaneous Radiofrequency Ablation for Histologically Proven Colorectal Lung Metastasis
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Long-Term Outcomes in Percutaneous Radiofrequency Ablation for Histologically Proven Colorectal Lung Metastasis Jim Zhong1 • Ebrahim Palkhi1 • Helen Ng2 • Kevin Wang2 • Richard Milton3 Nilanjan Chaudhuri3 • James Lenton1 • Jonathan Smith1 • Bobby Bhartia1 • Tze Min Wah1
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Received: 5 May 2020 / Accepted: 5 August 2020 The Author(s) 2020
Abstract Introduction To evaluate the long-term outcome of imageguided radiofrequency ablation (RFA) when treating histologically confirmed colorectal lung metastasis in terms of overall survival (OS), progression-free survival (PFS) and local tumour control (LTC). Materials and Methods Retrospective single-centre study. Consecutive RFA treatments of histologically proven lung colorectal metastases between 01/01/2008 and 31/12/14. The primary outcome was patient survival (OS and PFS). Secondary outcomes were local tumour progression (LTP) and complications. Prognostic factors associated with OS/ PFS were determined by univariate and multivariate analyses.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00270-020-02623-1) contains supplementary material, which is available to authorized users.
Results Sixty patients (39 males: 21 females; median age 69 years) and 125 colorectal lung metastases were treated. Eighty percent (n = 48) also underwent lung surgery for lung metastases. Mean metastasis size (cm) was 1.4 ± 0.6 (range 0.3–4.0). Median number of RFA sessions was 1 (1–4). During follow-up (median 45.5 months), 45 patients died (75%). The estimated OS and PFS survival rates at 1, 3, 5, 7, 9 years were 96.7%, 74.7%, 44.1%, 27.5%, 16.3% (median OS, 52 months) and 66.7%, 31.2%, 25.9%, 21.2% and 5.9% (median PFS, 19 months). The LTC rate was 90% with 6 patients developing LTP with 1-, 2-, 3- and 4-year LTP rates of 3.3%, 8.3%, 10.0% and 10.0%. Progression-free interval \ 1 year (P = 0.002, HR = 0.375) and total number of pulmonary metastases (C 3) treated (P = 0.037, HR = 0.480) were independent negative prognostic factors. Thirty-day mortality rate was 0% with no intra-procedural deaths.
& Tze Min Wah [email protected]
James Lenton [email protected]
Jim Zhong [email protected]
Jonathan Smith [email protected]
Ebrahim Palkhi [email protected]
Bobby Bhartia [email protected]
Helen Ng [email protected] Kevin Wang [email protected] Richard Milton [email protected] Nilanjan Chaudhuri [email protected]
1
Department of Diagnostic and Interventional Radiology, Institute of Oncology, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
2
University of Leeds, Woodhouse, Leeds LS2 9JT, UK
3
Department of Thoracic Surgery, Institute of Oncology, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
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J. Zhong et al.: Long-Term Outcomes in Percutaneous Radiofrequency Ablation…
Conclusion The long-term OS and PFS following RFA for the treatment of histologically confirmed colorectal lu
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