Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology
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CLINICAL INVESTIGATION
Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology Marco Calandri1,2 • Carlo Gazzera3 • Francesco Giurazza4 • Steven Yevich5 • Giulio Antonino Strazzarino3 • Jacopo Brino2 • Paolo Marra6 • Andrea Contegiacomo7 Irene Bargellini8 • Maurizio Cariati9 • Paolo Fonio3,10 • Andrea Veltri1,2
•
Received: 8 December 2019 / Accepted: 2 May 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Aim European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network guidelines (NCCN) have recently included interventional procedures among the standard treatments for the management of colorectal cancer (CRC) oligometastatic disease (OMD). This study overviews the practice of Interventional Radiology (IR) in Italian centers.
& Marco Calandri [email protected] 1
Department of Oncology, University of Torino, Regione Gonzole 10, Orbassano, TO, Italy
2
Radiology Unit, A.O.U. San Luigi Gonzaga Di Orbassano, Regione Gonzole 10, Orbassano, TO, Italy
3
Radiology Unit, A.O.U. Citta` Della Salute E Della Scienza, Presidio Molinette, Via Genova 3, Torino, TO, Italy
4
Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Cardarelli 9, Napoli, Italy
5
Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
6
Radiology Department, IRCCS Ospedale San Raffaele E Universita` Vita-Salute, Via Olgettina 60, Milan, Italy
7
Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136 Rome, Italy
8
Department of Interventional Radiology, Pisa University Hospital, Pisa, Italy
9
Diagnostic-Therapeutic Advanced Technology Department, ASST Santi Paolo E Carlo, Via Pio II 3, 20153 Milan, Italy
10
Department of Surgical Sciences, University of Torino, Via Genova 3, Torino, Italy
Methods A practice focused questionnaire on locoregional treatments of CRC-OMD was submitted to all Italian IR centers to assess practice patterns. Results Thirty-three IR centers completed the questionnaire. The majority reported practice was established within a tumor board (97%), which included input from hepatobiliary surgery (94%). When considering the number of percutaneous ablation and liver-directed trans-arterial therapies performed for all tumor types, 33.5% and 13.4% were performed to specifically treat CRC-OMD. Lung ablations for CRC OMD were performed in 45.5% of centers. Regarding liver ablation, The most common technology was the microwave ablation (68.1%), which was typically performed under US guidance (78%) with conscious sedation used as the most common anaesthesia method (81%). While indication for percutaneous IR treatments was heterogeneous, 51% were performed in combination with chemotherapy in unresectable OMD. Despite new ESMO and NCCN guidelines, 59% of centers did not subjectively appreciate any
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