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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  ;  Seong Yong Park 
 ANNALS OF SURGERY, Vol.278(1) : e173-e178, 2023-07 
Journal Title
Issue Date
Colorectal Neoplasms* / pathology ; Humans ; Lung Neoplasms* / surgery ; Retrospective Studies
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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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Han Sang(김한상) ORCID logo https://orcid.org/0000-0002-6504-9927
Park, Byung Jo(박병조)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Lee, Byung Min(이병민)
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
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