626 - What to choose as radical local treatment for lung metastases from colo-rectal cancer: surgery, radiofrequency ablation or stereotactic radiotherapy?

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Roel Schlijper
Authors R. Schlijper1, D. De Ruysscher2, J.P. Grutters3, R. Houben4, A.C. Dingemans5, J.E. Wildberger6, D.V. Raemdonck7, E. Van Cutsem8, G. Lammering4, P. Lambin9
  • 1Faculty Of Health, Medicine And Life Sciences, School Of Medicine, Maastricht University, 6211LK - Maastricht/NL
  • 2Radiation Oncology, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 3Department Of Health Service Research, School For Public Health And Primary Care (caphri), Maastricht University, Maastricht/NL
  • 4Department Of Radiation Oncology, Maastro Clinic, Maastricht/NL
  • 5Pulmonology, Maastricht University Medical Center (MUMC), NL-6202 AZ - Maastricht/NL
  • 6Department Of Radiology, Maastricht University Medical Center, Maastricht/NL
  • 7Department Of Thoracic Surgery, University Hospital Leuven, Leuven/BE
  • 8Digestive Oncology, University Hospital Leuven, 3000 - Leuven/BE
  • 9Maastro Clinic, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL

Abstract

Background

Long-term survival can be obtained with local treatment of lung metastases from colorectal cancer. However, it is unclear as to what the optimal local therapy is: surgery, radiofrequency ablation (RFA) or stereotactic radiotherapy (SBRT).

Methods

After a systematic review, 27 studies were included matching with the a priori selection criteria, the most important being at least 50 patients and a follow-up period of ≥ 24 months. However, no SBRT studies were eligible. The review was therefore conducted on 4 RFA and 23 surgical series.

Results

Four of the surgical studies were prospective, all others were retrospective. No randomized trial was found. The reported data differed between the studies, which led to difficulties in the analyses. Treatment-related mortality rates for RFA and surgery were 0% and 1.4-2.4%, respectively, whereas morbidity rates were reported inconsequently but seemed the lowest for surgery. Weighted 2- and 5-year survival were 69.6% and 40.7% for RFA and 76.5% and 44.9% for surgery.

Conclusion

Due to the lack of phase III trials, no firm conclusions can be drawn, although most evidence supports surgery. High-quality trials comparing currently used treatment modalities such as SBRT, RFA and surgery are needed.

Disclosure

All authors have declared no conflicts of interest.