CT-Guided Percutaneous Cryoablation for Lung Metastasis of Colorectal Cancer: A Case Series

Technol Cancer Res Treat. 2023 Jan-Dec:22:15330338231201508. doi: 10.1177/15330338231201508.

Abstract

Purpose: This study aimed to evaluate the efficacy of computed tomography (CT) guided percutaneous cryoablation (CA) for the management of lung metastases in patients with metastatic colorectal cancer (mCRC).

Methods: Retrospective analysis was performed on 38 mCRC patients with lung metastases, who underwent CT-guided percutaneous CA at our center from May 1, 2020 to November 1, 2021. The technical success rate, 1-year local control (LC) rate, recurrence-free survival (RFS) and treatment-related complications were analyzed.

Results: The CA procedure was successfully performed in all patients, with a technical success rate of 100%. The 1-year LC rate was 94.7% (36/38), while 16 patients experienced new distant lung metastases during the follow-up period. The median RFS was 20 months (95% CI: 13.0-27.0). The median RFS of patients with and without extrapulmonary metastasis was 15 and 23 months, respectively. Complications were reported in 18 (47.4%) patients following the CA procedure. Pneumothorax was discovered in 15 (39.5%) patients, and five of these patients (13.2%) required chest tube intubation. Two patients (5.3%) presented with hemoptysis during the CA procedure. One patient developed subcutaneous emphysema as detected in the post-procedure follow-up imaging. All patients tolerated the peri-procedural pain well under local anesthesia, and the mean visual analog scale (VAS) score was 2.8.

Conclusion: Lung CA is a safe and well-tolerated treatment with a satisfactory local control rate for patients with lung metastases derived from mCRC.

Keywords: colorectal cancer; cryoablation; lung cancer; outcomes; safety.

MeSH terms

  • Cryosurgery* / adverse effects
  • Cryosurgery* / methods
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / surgery
  • Rectal Neoplasms*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome