Management of potentially curable colorectal lung metastases with synchronous systemic therapy and percutaneous image-guided thermal ablation

Q: What was the primary objective of the study?

To evaluate survival benefits of synchronous systemic therapy plus thermal ablation (TA) for oligometastatic colorectal lung metastases and identify independent prognostic factors.

Q: How were patients grouped in the study?

Patients were stratified by the timing of systemic therapy relative to TA: synchronous therapy, upfront ablation, delayed ablation, and no systemic therapy.

Q: What did the results show about synchronous systemic therapy?

Synchronous systemic therapy produced the longest median progression-free survival (PFS) and overall survival (OS) and acted as an independent protective factor for both.

Sep 30, 2026

Uploaded by Nguyễn Văn Học

Objective: assess the survival benefit of synchronous systemic therapy plus thermal ablation (TA) in oligometastatic colorectal lung metastases and determine independent prognostic factors. Methods: retrospective cohort of 326 patients undergoing TA at six tertiary centers (Mar 2014–Oct 2022), stratified by systemic-therapy timing versus TA; Kaplan–Meier and log-rank analyses were used. Results: synchronous therapy showed longest median PFS and OS, serving as independent protective factors; tumor progression and OS were driven by size, location, tumor number, metastasis pattern, tumor burden, and mediastinal lymph node involvement. Conclusions: combining synchronous systemic therapy with TA improves PFS and OS in potentially curable patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

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Abstract

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AnnAls of Medicine 2026, Vol. 58, no. 1, 2612393 [https://doi.org/10.1080/07853890.2025.2612393](https://doi.org/10.1080/07853890.2025.2612393) RESEARCH ARTICLE Management of potentially curable colorectal lung metastases with synchronous systemic therapy and percutaneous image-guided thermal ablation Hongjie Fana,b,c*, Bufu Tangd*, Xiangjun Donga,b,c*, Yulan Zenge, Xinyue Gue, Xiangwen Xiaa,b,c, Jihong Huf, Cheng Wanf, Rong Dingg, Xinghai Lih, Fenhua Zhaoi, Chunlong Fui, Jiangping Cunj, An Lik, Xuancheng Xiel, Shufeng Xum, Kun Qiana,b,c, Xuefeng Kana,b,c and Chuansheng Zhenga,b,c adepartment of Radiology, Union Hospital, Tongji Medical college, Huazhong University of science and Technology, Wuhan, china; bHubei Provincial clinical Research center for Precision Radiology & interventional Medicine, Wuhan, china; cHubei Provincial Key laboratory of Molecular imaging, Wuhan, china; ddepartment of Radiation oncology, Zhongshan Hospital, fudan University, shanghai, china; ecancer center, Union Hospital, Tongji Medical college, Huazhong University of science and Technology, Wuhan, china; fdepartment of Minimally invasive intervention, The first Affiliated Hospital of Kunming Medical University, Kunming, china; gdepartment of Minimally invasive intervention, Yunnan cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, china; hdepartment of Minimally invasive intervention, Ganzhou People’s Hospital, Ganzhou, china; idepartment of Radiology, Affiliated dongyang Hospital of Wenzhou Medical University, dongyang, china; jdepartment of Radiology, second Affiliated Hospital of Kunming Medical University, Kunming, china; kdepartment of interventional, Xiangyang central Hospital, Affiliated Hospital of Hubei University of Arts and sciences, Xiangyang, china; ldepartment of Radiology, The first People’s Hospital of Yunnan Province, Kunming, china; mdepartment of Radiology, Quzhou Hospital Affiliated to Wenzhou Medical University, Quzhou, china ABSTRACT Objective: To assess the survival benefit of synchronous systemic therapy plus thermal ablation (TA) in oligometastatic colorectal lung metastases (CRLM) and identify independent prognostic factors. Background: Optimizing the integration of systemic therapy and TA for potentially curable CRLM remains a significant clinical challenge. Methods: This study employed a retrospective cohort design, including 326 patients who underwent TA treatment at six tertiary medical centers from March 2014 to October 2022. Patients were categorized into synchronous therapy, upfront ablation, delayed ablation, and no systemic therapy groups based on the timing of systemic therapy relative to TA. Kaplan–Meier analysis and log-rank tests were used to assess survival outcomes. Results: Synchronous systemic therapy yielded the longest median progression-free survival (PFS) (22.0 months) and overall survival (OS) (61.3 months) compared to delayed ablation (13.0 and 49.2 months, respectively) and no systemic therapy (11.9 and 29.3 months, respectively) (all p < 0.05). Synchronous systemic therapy was an independent protective factor for PFS [hazard ratio (HR) = 0.493] and OS (HR = 0.211). Independent risk factors for local tumor progression included tumor size ≥3 cm (HR = 1.75) and peridiaphragmatic location (HR = 1.48). For PFS, independent predictors included tumor numbers (p < 0.001), synchronous metastases (HR = 1.431), and extrapulmonary metastases (p = 0.001). OS was adversely influenced by tumor burden (p < 0.05), extrapulmonary metastases (p < 0.001), and mediastinal lymph node involvement (HR = 1.518). Conclusions: Synchronous systemic therapy combined with TA significantly enhances PFS and OS in potentially curable oligometastatic CRLM patients. ARTICLE HISTORY Received 9 June 2025 Revised 14 October 2025 Accepted 30 December 2025 KEYWORDS Colorectal lung metastases; image-guided thermal ablation; systemic therapy; survival outcomes; local tum

FAQs

What was the primary objective of the study?

To evaluate survival benefits of synchronous systemic therapy plus thermal ablation (TA) for oligometastatic colorectal lung metastases and identify independent prognostic factors.

How were patients grouped in the study?

Patients were stratified by the timing of systemic therapy relative to TA: synchronous therapy, upfront ablation, delayed ablation, and no systemic therapy.

What did the results show about synchronous systemic therapy?

Synchronous systemic therapy produced the longest median progression-free survival (PFS) and overall survival (OS) and acted as an independent protective factor for both.

Sep 30, 2026

Uploaded by Nguyễn Văn Học