• Annals of surgery · Jul 2023

    Importance of Local Ablative Therapies for Lung Metastases in Patients With Colorectal Cancer.

    • Byung Min Lee, Jee Suk Chang, Woong Sub Koom, Hwa Kyung Byun, Han Sang Kim, Seung-Hoon Beom, Caleb Oh, Young Joo Suh, Joong Bae Ahn, Sang Joon Shin, Byung Jo Park, and Seong Yong Park.
    • Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
    • Ann. Surg. 2023 Jul 1; 278 (1): e173e178e173-e178.

    ObjectiveTo assess the effect of local ablative therapy (LAT) on overall survival in patients with lung metastases from colorectal cancer (CRC) compared with patients treated with systemic therapy.Summary Background DataCRC affects approximately 1.4 million individuals worldwide every year. The lungs are commonly affected by CRC, and there is no treatment standard for a secondary lung metastasis from CRC.MethodsThis longitudinal, retrospective cohort study (2010-2018) quantified the pulmonary and extrapulmonary tumor burden of 1143 patients by retrospectively reviewing computed tomography images captured at diagnosis. A comprehensive multidisciplinary approach informed how and when surgery and/or stereotactic body radiotherapy was administered.ResultsAmong 1143 patients, 473 patients (41%) received LAT, with surgery first (n = 421) or stereotactic ablative radiation therapy first (n = 52) either at the time of diagnosis (n = 288), within 1 year (n = 132), or after 1 year (n = 53). LAT was repeated in 158 patients (33.4%, 384 total sessions) when new lung metastases were detected. The 5- and 10-year survival rates for patients treated with LAT (71.2% and 64.0%, respectively) were significantly higher than those of patients treated with systemic therapy alone (14.2% and 10.0%, respectively; P <0.001). The overall survival of patients who received LAT intervention increased as the total tumor burden decreased.ConclusionsA high long-term survival rate was achievable in a significant portion of patients with lung metastasis from CRC by the timely administrations of LAT to standard systemic therapy. The tumor burden and LAT feasibility should be included in a discussion during the follow-up period.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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