Extrapulmonary metastases impact survival outcomes of thermal ablation for colorectal lung oligometastases: A multicenter study

Figure 3 Kaplan-Meier survival curves for overall survival stratified by prognostic factors. Survival curves illustrate the impact of various clinical and tumor-related factors on overall survival (OS) in patients with colorectal cancer lung metastases undergoing image-guided thermal ablation. A: Elevated carbohydrate antigen 19-9 (> 37 U/mL) was associated with significantly worse OS [hazard ratio (HR) = 1.592]; B: Tumor size ≥ 3 cm correlated with poorer OS compared to tumors < 3 cm (HR = 1.446); C: Increasing tumor number independently predicted worse outcomes, with hazard ratios of 1.446, 2.561, and 2.137 for 2, 3, and 4 tumors, respectively, relative to a single tumor; D: Systemic therapy and its timing were important predictors of OS. Lack of systemic therapy was associated with poorer prognosis, whereas delayed (HR = 0.670), synchronous (HR = 0.551), and upfront ablation (HR = 0.546) improved OS compared to no systemic therapy; E: Tumor differentiation significantly influenced survival; Poorly differentiated tumors (HR = 2.769) had worse outcomes compared to well-differentiated tumors, while other differentiation grades had variable impact; F: Presence and site of extrapulmonary metastasis markedly reduced OS, particularly in bone (HR = 4.538), abdominal cavity (HR = 4.813), pelvic cavity (HR = 3.105), and other sites (HR = 5.230), when compared to patients without extrapulmonary metastases. CA: Carbohydrate antigen. A higher hazard ratio indicates a greater risk of mortality.