Oligometastatic Colorectal Cancer Management: A Survey of the Italian College of Interventional Radiology

Marco Calandri, Carlo Gazzera, Francesco Giurazza, Steven Yevich, Giulio Antonino Strazzarino, Jacopo Brino, Paolo Marra, Andrea Contegiacomo, Irene Bargellini, Maurizio Cariati, Paolo Fonio, Andrea Veltri

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network guidelines (NCCN) have recently included interventional procedures among the standard treatments for the management of colorectal cancer (CRC) oligometastatic disease (OMD). This study overviews the practice of Interventional Radiology (IR) in Italian centers. Methods: A practice focused questionnaire on locoregional treatments of CRC-OMD was submitted to all Italian IR centers to assess practice patterns. Results: Thirty-three IR centers completed the questionnaire. The majority reported practice was established within a tumor board (97%), which included input from hepatobiliary surgery (94%). When considering the number of percutaneous ablation and liver-directed trans-arterial therapies performed for all tumor types, 33.5% and 13.4% were performed to specifically treat CRC-OMD. Lung ablations for CRC OMD were performed in 45.5% of centers. Regarding liver ablation, The most common technology was the microwave ablation (68.1%), which was typically performed under US guidance (78%) with conscious sedation used as the most common anaesthesia method (81%). While indication for percutaneous IR treatments was heterogeneous, 51% were performed in combination with chemotherapy in unresectable OMD. Despite new ESMO and NCCN guidelines, 59% of centers did not subjectively appreciate any change in the perception of IR treatments by other specialists; however, 63%of respondents believe that IR will have a more relevant role in the CRC-OMD management in the future. Conclusion: CRC-OMD treatment represents a relevant part of the everyday clinical practice of the IR Italian centers with promising future prospects. Heterogeneity persists in clinical indications, requiring more robust evidence to set indications and to diffuse clinical applications.

Original languageEnglish
Pages (from-to)1474-1483
Number of pages10
JournalCardioVascular and Interventional Radiology
Volume43
Issue number10
DOIs
Publication statusPublished - Oct 1 2020

Keywords

  • Colorectal cancer
  • Interventional radiology
  • Metastases
  • Oligometastatic disease
  • Survey
  • Thermal ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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