Combination polypectomy or excisional biopsy with interventional radiology local tumor destruction versus polypectomy or excisional biopsy for colon cancer: A SEER database analysis.

e15657 Background: Colon cancer is one of the most common forms of cancer, affecting millions of individuals worldwide. Despite advances in surgical and systemic therapies, a significant proportion of patients still present with locally advanced or metastatic disease. Interventional radiology has emerged as a crucial tool in the management of colon cancer, offering a number of minimally invasive treatments aimed at locally destroying the tumor. This study aims to assess the effectiveness and prognostic impact of various interventional radiology treatments for colon cancer. Methods: We queried the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with primary colon cancer from the cecum to the sigmoid (primary site codes C180-189), including the appendix, diagnosed between 2000-2019. Patients were included if management of the primary tumor included either excisional biopsy, polypectomy, and/or local tumor destruction (LTD) via photodynamic therapy, electrocautery, cryosurgery, or laser ablation (surgical codes 21-24). Variables included for Kaplan-Meier, Chi-square, and Cox Regression analyses were age at diagnosis, sex, race, stage, and surgical management subtype status. Results: A total of 18164 patients were collected from this search of which 775 patients underwent a combination polypectomy or excisional biopsy with LTD, 6997 patients underwent polypectomy alone, 1619 patients underwent excisional biopsy alone, 7959 patients underwent endoscopic polypectomy alone, 814 patients underwent a surgical excision polypectomy alone. On Kaplan-Meier, the combination polypectomy or excisional biopsy with LTD showed better survival than excisional biopsy alone (p < 0.001). The combination treatment showed similar survivability to polypectomy NOS, endoscopy polypectomy alone, and surgical excision polypectomy alone. The one-, three-, and five-year survival rates of combination treatment were 97.0%, 94.7%, and 93.4%, respectively, which is significantly greater than excisional biopsy at all time points (p’s < 0.001) and within 1% of all other treatments at all time points. On Cox regression, no differences in survival were observed between groups. Of note the demographics of older age (p < 0.001), black race (p < 0.001), American Indian/Alaska Native (p = 0.044), regional spread of tumor ( < 0.001), and distant spread of tumor (p < 0.0001) were all associated with worse survival outcomes. Conclusions: Combination polypectomy or excisional biopsy with interventional radiology LTD procedures are associated with improved survival compared to excisional biopsy alone for the treatment of colon cancer. Our results suggest these interventional radiology procedures may be effective additional management options for the management of primary colon tumors.