Percutaneous cryoablation of pulmonary metastases from colorectal cancer

Yoshikane Yamauchi, Yotaro Izumi, Masafumi Kawamura, Seishi Nakatsuka, Hideki Yashiro, Norimasa Tsukada, Masanori Inoue, Keisuke Asakura, Hiroaki Nomori, Yoshikane Yamauchi, Yotaro Izumi, Masafumi Kawamura, Seishi Nakatsuka, Hideki Yashiro, Norimasa Tsukada, Masanori Inoue, Keisuke Asakura, Hiroaki Nomori

Abstract

Objective: To evaluate the safety and efficacy of cryoablation for metastatic lung tumors from colorectal cancer.

Methods: The procedures were performed on 24 patients (36-82 years of age, with a median age of 62; 17 male patients, 7 female patients) for 55 metastatic tumors in the lung, during 30 sessions. The procedural safety, local progression free interval, and overall survival were assessed by follow-up computed tomographic scanning performed every 3-4 months.

Results: The major complications were pneumothorax, 19 sessions (63%), pleural effusion, 21 sessions (70%), transient and self-limiting hemoptysis, 13 sessions (43%) and tract seeding, 1 session (3%). The 1- and 3-year local progression free intervals were 90.8% and 59%, respectively. The 3-years local progression free intervals of tumors ≤15 mm in diameter was 79.8% and that of tumors >15 mm was 28.6% (p = 0.001; log-rank test). The 1- and 3-year overall survival rates were 91% and 59.6%, respectively.

Conclusion: The results indicated that percutaneous cryoablation is a feasible treatment option. The local progression free interval was satisfactory at least for tumors that were ≤15 mm in diameter.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Local progression free interval curve.
Figure 1. Local progression free interval curve.
The median follow-up period was 40 months. Up to the date of the last follow-up of each patient, 17 tumors (26%) showed disease progression at the original cryoablation site, and hence median local progression free interval could not be determined. Local progression free interval at 1- and 3-years after treatment was 90.8% and 59%, respectively.
Figure 2. Local progression free interval curve…
Figure 2. Local progression free interval curve according to tumor diameter.
Local progression free interval was significantly greater for lesions with a diameter less than 15 mm. The 3-years local progression free interval of tumors ≤15 mm in diameter was 79.8% and that of tumors >15 mm in diameter was 28.6% (p = 0.001, log-rank test).
Figure 3. The overall survival curve after…
Figure 3. The overall survival curve after first cryoablation.
Median overall survival was 43 months (8–86). One- and 3-year overall survival rates of 91% and 59.6%, respectively.

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