Percutaneous Cryoablation Under Local Anesthesia for Pulmonary Metastases From Colorectal Cancer: Long-Term Outcomes From a Single-Institution Retrospective Cohort

Background: Surgical resection is the standard treatment for pulmonary metastases from colorectal cancer, but its safety and long-term efficacy in medically inoperable patients remain limited. Percutaneous cryoablation is a minimally invasive alternative to surgical resection and has gained increasing attention in recent years. Aims: This retrospective study aimed to evaluate complication rates, local tumor control, and overall survival associated with percutaneous cryoablation for pulmonary metastases from colorectal cancer. Methods and Results: We retrospectively reviewed patients treated with percutaneous cryoablation from 2002–2017. Complications were defined as adverse events ≥ grade 2 per Common Terminology Criteria for Adverse Events version 5.0. In total, 126 metastatic pulmonary tumors in 48 patients were treated across 73 sessions. Complications occurred in 18 sessions (24.7%), including 2 grade ≥ 3 events (2.7%). No treatment-related deaths occurred within 30 days. With a median follow-up of 9.7 months (maximum, 155.4 months), local tumor control rates at 1, 3, and 5 years were 74.5%, 58.8%, and 56.4%, respectively. Median overall survival was 3.8 years, with 1-, 3-, 5-, and 10-years rates of 86.8%, 60.4%, 41.9%, and 36.6%, respectively. The relatively short median follow-up should be considered when interpreting these long-term local control estimates. Six patients achieved 10-years survival. Conclusion: Percutaneous cryoablation is a safe, minimally invasive option that provides favorable local tumor control and encouraging long-term survival outcomes.