Local progression after radiofrequency ablation for pulmonary metastases

• Published in: Cancer Vol. 117; no. 16; pp. 3781 - 3787
• Main Authors: von Meyenfeldt, Erik M., Prevoo, Warner, Peyrot, David, Fat, Nathalie Lai A, Burgers, Sjaak J. A., Wouters, Michel W., Klomp, Houke M.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.08.2011; Wiley-Blackwell
• Subjects: Adult; Aged; Biological and medical sciences; Catheter Ablation - adverse effects; Catheter Ablation - methods; Disease Progression; Female; Humans; local ablation techniques; local progression; lung; Lung Neoplasms - mortality; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Male; Medical sciences; metastasis; Middle Aged; Neoplasm Recurrence, Local; oligometastatic disease; progression‐free survival; radiofrequency ablation; survival; Tumors; Lung; progression-free survival; survival; Malignant tumor; Metastasis; Radiofrequency; Respiratory system; local ablation techniques; oligometastatic disease; Cancerology; Progression free survival; Technique; radiofrequency ablation; Cancer; local progression
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.25958

BACKGROUND: Local treatment for pulmonary metastases is considered to be a reasonable treatment option in patients with oligometastatic disease. Percutaneous radio frequency ablation (RFA) has been reported as an alternative to surgery. Results of RFA for local control of pulmonary metastases were evaluated. METHODS: All consecutive patients treated with RFA for pulmonary metastases (2004‐2009) were included. RFA was performed percutaneously under computed tomographic guidance. Follow‐up was scheduled at 1, 3, and 6 months after treatment and every 6 months thereafter. Major outcome parameters were local and any‐site progression, complications, and survival. RESULTS: Ninety pulmonary metastases were treated, in 46 patients at 65 sessions. Many patients had recurrent metastases after previous surgery (n = 36 of 46). Pneumothorax occurred in 34% (chest drain in 25%) and major complications in 6%. After median follow‐up of 22 months (range, 2‐65 months), 25 local progressions occurred after RFA; the 2‐year local progression rate per lesion was 35%. Overall survival at 3 years was 69%. CONCLUSIONS: Notwithstanding its relatively low morbidity, follow‐up after RFA for pulmonary metastases shows a considerable rate of local progression. The role of local ablation techniques for long‐term disease control in oligometastatic disease is discussed. Cancer 2011. © 2011 American Cancer Society. Radiofrequency ablation (RFA) for pulmonary (oligo)metastatic disease is associated with a considerable rate of local progression (>30%). Nevertheless, long‐term survival rates are still acceptable after repeated RFA.