Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Radiofrequency ablation with or without capecitabine maintenance therapy for lung oligometastases from colorectal cancer
Ke-Ning Li, Lei-Lei Ying, Nan Du, Ying Wang, Hao-Zhe Huang, Yao-Hui Wang, Li-Chao Xu, Qing Zhao, Ge Song, Yu-Bin Hu, Wen-Tao Li, Yan Yan, Chao Chen, Xin-Hong He
Ke-Ning Li, Lei-Lei Ying, Nan Du, Ying Wang, Hao-Zhe Huang, Yao-Hui Wang, Li-Chao Xu, Qing Zhao, Ge Song, Wen-Tao Li, Yan Yan, Chao Chen, Xin-Hong He, Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Ke-Ning Li, Lei-Lei Ying, Nan Du, Ying Wang, Hao-Zhe Huang, Yao-Hui Wang, Li-Chao Xu, Qing Zhao, Ge Song, Wen-Tao Li, Yan Yan, Chao Chen, Xin-Hong He, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Yu-Bin Hu, Department of Tumor and Vascular Interventional Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350000, Fujian Province, China
Co-first authors: Ke-Ning Li and Lei-Lei Ying.
Co-corresponding authors: Chao Chen and Xin-Hong He.
Author contributions: Li KN, and Ying LL wrote the original draft, they contributed equally to this article, they are the co-first authors of this manuscript; Chen C, He XH and Li KN designed the study; Chen C and Li KN designed the methodology of study and analyzed all data; He XH, Chen C, Du N, Wang Y, Huang HZ, Xu LC, Zhao Q, Song G, Hu YB, Li WT, Yan Y, Wang YH performed the ablation procedure as well as documented all data related to radiofrequency ablation; He XH made thoroughly review and editing of the manuscript; He XH and Chen C contributed equally to this article, they are the co-corresponding authors of this manuscript; All authors thoroughly reviewed and endorsed the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82072034.
Institutional review board statement: The study was reviewed and approved by the Fudan University Shanghai Cancer Center Institutional Review Board (No. 1612127-18) and Fujian Cancer Hospital Ethics Committee (No. K2025-206-01).
Informed consent statement: This is a retrospective study, so informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated and analyzed during this study are not publicly available due to institutional ethical regulations and patient confidentiality protections. However, de-identified data supporting the findings of this study are available from the corresponding author (Chen C,
chaochen_cc@fudan.edu.cn) upon reasonable request. Data requests will be reviewed by the institutional ethics committee to ensure compliance with privacy policies. Approved requests may require a formal data sharing agreement outlining terms of use, including prohibitions on re-identification attempts and restrictions on redistribution. All shared data will remain anonymized, consistent with the original study protocol.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xin-Hong He, MD, Doctor, Department of Interventional Radiology, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Xuhui District, Shanghai 200032, China.
xinhong.he@shca.org.cn
Received: May 30, 2025
Revised: July 7, 2025
Accepted: August 15, 2025
Published online: September 21, 2025
Processing time: 111 Days and 10.1 Hours
BACKGROUND
No clear guidelines for long-term postoperative maintenance therapy have been established for patients with lung oligometastases from colorectal cancer (CRC) who achieve radiological no evidence of disease after radiofrequency ablation (RFA) treatment. We compared the outcomes of patients with lung oligometastases from CRC after RFA plus maintenance capecitabine with RFA alone.
AIM
To determine whether adding capecitabine to RFA improves prognosis compared with RFA alone.
METHODS
This multicenter retrospective study included consecutive patients from two tertiary cancer centers treated for pulmonary oligometastases from CRC between 2016 and 2023. Subjects were assigned to RFA plus capecitabine (combined) or RFA alone (only RFA) groups. Primary outcomes included overall survival (OS) and progression-free survival (PFS) survival and the secondary outcome was local tumor progression (LTP). The OS, PFS, and LTP rates were compared between the two groups. In addition, prognostic factors were identified using univariate and multivariate analyses.
RESULTS
Combination therapy (RFA + capecitabine, n = 148) and RFA monotherapy (n = 99) were compared in patients with CRC and lung metastases. The median OS was 37.8 months (22.4, 50.3), the PFS was 18.7 months (13.0, 36.5), and the LTP was 31.5 months (20.0, 52.4) in the Only RFA group. The OS increased significantly (P = 0.011) and the LTP decreased at all time points (P < 0.001) in the combined group. The multivariate cox analysis revealed that combined chemotherapy significantly improved OS, with hazard ratios ranging from 0.29 to 0.35 (all P < 0.015) after adjusting for demographic, tumor, and treatment-related factors. The risk of death was consistently lower in the combination therapy group compared to RFA monotherapy.
CONCLUSION
RFA prolongs survival and local control in patients with CRC pulmonary oligometastases. Adjuvant capecitabine increases OS and reduces LTP compared to RFA alone, but PFS did not significantly change.
Core Tip: This multicenter retrospective analysis demonstrates that adding maintenance capecitabine after achieving no evidence of disease with radiofrequency ablation (RFA) significantly improves survival outcomes in colorectal cancer patients with lung oligometastases. Compared to RFA alone, the RFA-plus-capecitabine group showed superior 5-year overall survival and significantly reduced local tumor progression, although progression-free survival was unchanged. This study provides the first evidence supporting capecitabine maintenance therapy following RFA-induced no evidence of disease as a strategy to enhance long-term survival and local control in this oligometastatic population.
