TY - JOUR
T1 - What to choose as radical local treatment for lung metastases from cob-rectal cancer: Surgery or radiofrequency ablation?
AU - Schlijper, Roe C. J.
AU - Grutters, Janneke P. C.
AU - Houben, Ruud
AU - Dingemans, Anne-Marie C.
AU - Wildberger, Joachim E.
AU - Van Raemdonck, Dirk
AU - Van Cutsem, Eric
AU - Haustermans, Karin
AU - Lammering, Guido
AU - Lambin, Philippe
AU - De Ruysscher, Dirk
PY - 2014/2
Y1 - 2014/2
N2 - 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: A systematic review included 27 studies matching with the a priori selection criteria, the most important being >= 50 patients and a follow-up period of >= 24 months. 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 reporting of 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 inconsistently but seemed the lowest for surgery. Conclusion: Due to the lack of phase III trials, no firm conclusions can be drawn, although most evidence supports surgery as the most effective treatment option. High-quality trials comparing currently used treatment modalities such as SBRT, RFA and surgery are needed to inform treatment decisions.
AB - 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: A systematic review included 27 studies matching with the a priori selection criteria, the most important being >= 50 patients and a follow-up period of >= 24 months. 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 reporting of 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 inconsistently but seemed the lowest for surgery. Conclusion: Due to the lack of phase III trials, no firm conclusions can be drawn, although most evidence supports surgery as the most effective treatment option. High-quality trials comparing currently used treatment modalities such as SBRT, RFA and surgery are needed to inform treatment decisions.
KW - Lung metastases
KW - Colon cancer
KW - Rectal cancer
KW - Cancer
KW - Surgery
KW - RFA
U2 - 10.1016/j.ctrv.2013.05.004
DO - 10.1016/j.ctrv.2013.05.004
M3 - Article
SN - 0305-7372
VL - 40
SP - 60
EP - 67
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
IS - 1
ER -