Percutaneous Radiofrequency Ablation for Pulmonary Metastases from Esophageal Cancer: Retrospective Evaluation of 21 Patients

• Published in: Journal of vascular and interventional radiology Vol. 25; no. 10; pp. 1566 - 1572
• Main Authors: Matsui, Yusuke, MD, Hiraki, Takao, MD, Gobara, Hideo, MD, Fujiwara, Hiroyasu, MD, Iguchi, Toshihiro, MD, Shirakawa, Yasuhiro, MD, Fujiwara, Toshiyoshi, MD, Toyooka, Shinichi, MD, Kanazawa, Susumu, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2014
• Subjects: Adult; Aged; Aged, 80 and over; Catheter Ablation - adverse effects; Catheter Ablation - mortality; Disease Progression; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms - mortality; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Male; Metastasectomy - adverse effects; Metastasectomy - methods; Metastasectomy - mortality; Middle Aged; Radiology; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2014.06.030

Abstract Purpose To evaluate retrospectively outcomes after radiofrequency (RF) ablation for pulmonary metastases from esophageal cancer. Materials and Methods This study included 21 consecutive patients who met inclusion criteria (all men; mean age, 66.0 y) and had pulmonary metastases from esophageal cancer. There were 31 tumors (mean size, 1.7 cm) that were treated with 27 planned ablation sessions. At the initial RF ablation sessions, 3 patients had viable extrapulmonary recurrences, and 18 patients had viable recurrences confined to the lung. Primary study endpoints included patient survival and the determination of prognostic factors. Secondary endpoints included local efficacy and safety of the treatment. The log-rank test was used to identify prognostic factors. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0. Results Median follow-up duration after the initial RF ablation was 22.4 months (range, 6.2–76.1 mo). Estimated overall survival rates were 85.7% at 1 year, 54.8% at 2 years, and 38.4% at 3 years after the initial RF ablation session. The presence of viable extrapulmonary recurrences at the initial RF ablation session was an unfavorable prognostic factor ( P < .001). Local tumor progression was observed in 25.8% (8 of 31) of tumors and occurred 2.6–10.0 months (median, 4.8 mo) after RF ablation. Grade 3 adverse events occurred in 7.4% (2 of 27) of sessions, including pleural effusion requiring chest tube placement and pneumoderma requiring surgical intervention. No grade 4 or greater adverse events occurred. Conclusions RF ablation is a promising treatment option for patients with pulmonary metastases from esophageal cancer.