ArticleFrontiers in oncology2026
Outcomes following different thermal ablation strategies in patients with oligometastatic colorectal lung metastases.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Image-guided thermal ablation (IGTA) is increasingly integrated with systemic therapy for oligometastatic colorectal cancer with lung metastases, but the optimal timing of ablation relative to systemic treatment remains unclear. This study evaluated whether treatment sequencing affects survival and local tumor control. Methods: This multicenter retrospective cohort study included 289 patients with oligometastatic colorectal lung metastases who underwent CT-guided percutaneous thermal ablation between April 2015 and April 2023. Patients were classified into delayed-ablation, simultaneous-ablation, and instant-ablation groups according to the timing of ablation relative to systemic therapy. Overall survival (OS), progression-free survival (PFS), and local tumor progression-free survival (LTPFS) were assessed using Cox regression and inverse probability of treatment weighting (IPTW) based on the average treatment effect framework. Results: The delayed-, simultaneous-, and instant-ablation groups included 118, 87, and 84 patients, respectively. The primary technical success rate was 97.5%, and secondary technical success reached 100%. After IPTW adjustment, simultaneous ablation was associated with a lower risk of death than delayed ablation (HR, 0.51; 95% CI, 0.27-0.96; P = 0.037), whereas instant ablation showed no OS advantage. Simultaneous ablation showed a trend toward improved PFS (HR, 0.75; 95% CI, 0.55-1.03; P = 0.076). instant ablation was associated with a higher risk of local tumor progression (HR, 2.62; 95% CI, 1.28-5.37; P = 0.008). No treatment-related deaths occurred. Conclusion: Simultaneous ablation was associated with longer OS in patients with oligometastatic colorectal lung metastases, whereas instant ablation may be associated with poorer local control. Prospective validation is warranted.
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