Cryoablation for treatment of peripheral lung metastases from colorectal cancer: a bicenter retrospective study

Jean Izaaryene; Rémi Grange; Vincent Habouzit; Sylvain Grange; Bastien Orsini; Michael Dassa; Nassima Daidj; Louis Thierry; Marjorie Ferre; Jean Marc Phelip; Bernard Lelong; Cécile De Chaisemartin; Emmanuel Mitry; Gilles Piana

doi:10.1007/s00330-024-11153-0

Cryoablation for treatment of peripheral lung metastases from colorectal cancer: a bicenter retrospective study

Eur Radiol. 2024 Nov 22. doi: 10.1007/s00330-024-11153-0. Online ahead of print.

Authors

Affiliations

¹ Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France. izaaryenej@ipc.unicancer.fr.
² Department of Interventional Radiology, University Hospital of Saint-Etienne, University Hospital of Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.
³ Department of Thoracic Surgery, Clairval Private Hospital, Ramsay Générale de Santé, Marseille, France.
⁴ Interventional Radiology Department, Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.
⁵ Surgery Department Institut Paoli Calmettes, Aix Marseille University, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.
⁶ Oncology Department, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.

PMID: 39572449
DOI: 10.1007/s00330-024-11153-0

Abstract

Objectives: To evaluate the oncological efficacy and complications of cryoablation (CA) in treating lung metastases from colorectal cancer (CRC) at the lung periphery.

Materials and methods: The inclusion criteria for this bicenter retrospective study included patients with histologically confirmed CRC, with radiologically confirmed lung metastases at the periphery of the lung (distance of less than or equal to 2 cm from the costal, diaphragmatic, or cervical pleura) treated with CA between January 2017 and June 2022. Patients with intra-parenchymal metastases or metastases close to the mediastinal pleura and patients without follow-up were excluded.

Results: Seventy-three patients were included (median age: 69 years, range 47.0-83.0; 38 males, 52.0%) with 113 metastases and 89 procedures. Technical success was achieved in all procedures. During follow-up (median 22 months), on a per metastasis basis, local recurrence occurred for 8/113 (7%) of the metastases in 7 patients at a median time of 19 months; 7 had concomitant distant recurrence. Local progression-free survival rates were 95% at 1 year and 89% at 2, 3, and 4 years. Distant progression occurred in 41/73 (56.2%) patients, significantly associated with a history of liver metastasis and synchronous lung metastasis (p < 0.05). The median chemotherapy-free survival was 14 (IQR (5.0-21.5)) months. Complications were predominantly mild or moderate, with a low incidence of severe complications.

Conclusion: CA demonstrates high rate of local control and appears well-tolerated in the treatment of peripheral lung metastases from CRC. The procedure offers a viable therapeutic option, allowing patients a significant period without chemotherapy.

Key points: Question Despite its advantages over surgery, data on cryoablation of metastases from colorectal cancer at the periphery of the lung are lacking. Findings Cryoablation enabled very good local control, with local progression-free survival rates of 95% at 1 year and 89% at 2, 3, and 4 years. Clinical relevance Cryoablation is an effective treatment for local tumor control of lung metastases from colorectal cancer at the periphery of the lung. The treatment is well tolerated and can provide patients with substantial relief from chemotherapy.

Keywords: Colorectal neoplasms; Cryotherapy; Lung; Neoplasm metastasis; Pleura.