Systemic Therapy Plus Thermal Ablation Versus Systemic Therapy Alone for Oligometastatic Liver Metastases from Non-small
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Systemic Therapy Plus Thermal Ablation Versus Systemic Therapy Alone for Oligometastatic Liver Metastases from Non-small Cell Lung Cancer Yanqing Zhao1 • Xiaowu Zhang1 • He Zhao1 • Tao Gong1 • Jingui Li1 Jiaywei Tsauo1 • Xiao Li1
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Received: 9 January 2020 / Accepted: 12 March 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose This study assessed and compared the efficacy and long-term outcomes of systemic therapy plus imageguided thermal ablation versus systemic therapy alone for oligometastatic liver metastases (LMs) from non-small cell lung cancer (NSCLC). Materials and Methods This retrospective study was approved by the institutional review board. Written informed consent was waived due to the retrospective design. From November 2012 to December 2017, 61 patients (mean age 59.0 years; 35 males) with oligometastatic LMs from NSCLC (B 5 metastatic lesions) who received systemic therapy with (n = 21, group A) or without (n = 40, group B) thermal ablation were analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier curves. Results The demographic and clinical characteristics were not significantly different between the groups (all P C .05). In total, 28 LMs were entirely ablated, rendering a technical success rate of 100%, without major complications. The overall 6-month response rate was significantly higher in group A than in group B [57.1% (12/21) vs. 26.3% (10/ 38); P = .026]. The median PFS in group A was significantly longer than in group B [11.0 (95% CI 7.9–16.2) & Jiaywei Tsauo [email protected] & Xiao Li [email protected] 1
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Panjiayuan Nanli 17#, Chaoyang District, Beijing 100021, China
months vs. 5.2 (95% CI 3.7–7.9) months; P = .001]. However, the median OS was not significantly different [27.7 (95% CI 20.6–44.4) months vs. 17.7 (95% CI 14.5–27.5) months; P = .152]. Conclusion Systemic therapy plus thermal ablation may prolong PFS but not OS in oligometastatic LMs from NSCLC. Keywords Non-small cell lung cancer Liver metastases Ablation Systemic therapy Progression-free survival
Introduction Lung cancer is the leading cause of cancer-related mortality worldwide [1]. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer cases and is usually advanced and unresectable at diagnosis [2]. The most common metastatic sites of NSCLC are the brain, bone, lung, liver, and adrenal gland [3]. Several studies have shown that liver metastasis (LM) is an independent negative survival prognostic factor in metastatic lung cancer patients [4–8]. The median overall survival (OS) in NSCLC patients with LM is considerably shorter than those without LM (5.0–20.8 months vs. 10.2–30.6 mon
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