Factors Affecting Local Progression after Percutaneous Cryoablation of Lung Tumors

• Published in: Journal of vascular and interventional radiology Vol. 24; no. 6; pp. 813 - 821
• Main Authors: Yashiro, Hideki, MD, Nakatsuka, Seishi, MD, PhD, Inoue, Masanori, MD, Kawamura, Masafumi, MD, PhD, Tsukada, Norimasa, MD, Asakura, Keisuke, MD, Yamauchi, Yoshikane, MD, Hashimoto, Kohei, MD, Kuribayashi, Sachio, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2013
• Subjects: Adult; Aged; Aged, 80 and over; Cryosurgery; Disease-Free Survival; Female; Humans; Japan - epidemiology; Lung Neoplasms - epidemiology; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Prevalence; Radiology; Risk Assessment; Risk Factors; Treatment Outcome; Japan; hazard ratio; percutaneous cryoablation of lung tumors; confidence interval; HR; CI; PCLT
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2012.12.026

Abstract Purpose To evaluate factors predicting local tumor progression after percutaneous cryoablation of lung tumors (PCLT). Materials and Methods Seventy-one consecutive patients with 210 tumors (11 primary and 199 metastatic pulmonary neoplasms; mean maximum diameter, 12.8 mm) were treated with 102 sessions of PCLT. Rates of local tumor progression and technique effectiveness were estimated by Kaplan–Meier method. Multiple variables were evaluated with the log-rank test, followed by uni- and multivariate multilevel analyses to identify independent risk factors, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. All statistical tests were two-sided. Results Median follow-up period was 454 days (range, 79–2,467 d). Local tumor progression occurred in 50 tumors (23.8%). One-, 2-, and 3-year local progression-free rates were 80.4%, 69.0%, and 67.7%, respectively, and technique effectiveness rates were 91.4%, 83.0%, and 83.0%, respectively. Existence of a thick vessel (diameter≥3 mm) no more than 3 mm from the edge of the tumor was assessed as an independent factor (HR, 3.84; 95% CI, 1.59–9.30; P = .003) associated with local progression by multivariate analysis. Conclusions Presence of a vessel at least 3 mm in diameter close to the tumor represents an independent risk factor for local progression after PCLT.