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. 2023 Jul 1;278(1):e173-e178.
doi: 10.1097/SLA.0000000000005466. Epub 2022 Jul 15.

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

Byung Min Lee  1   2 , Jee Suk Chang  1 , Woong Sub Koom  1 , Hwa Kyung Byun  1 , Han Sang Kim  3 , Seung-Hoon Beom  3 , Caleb Oh  1 , Young Joo Suh  4 , Joong Bae Ahn  3 , Sang Joon Shin  3 , Byung Jo Park  5 , Seong Yong Park  5   6
Affiliations

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

Byung Min Lee et al. Ann Surg. .

Abstract

Objective: To 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 data: CRC 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.

Methods: This 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.

Results: Among 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.

Conclusions: A 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.

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Conflict of interest statement

The authors report no conflicts of interest.

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