Radiofrequency ablation of lung metastasis not suitable for surgery: Experience in siriraj hospital

Abstract

© 2015, Medical Association of Thailand. All rights reserved. Background: Percutaneous image-guided radiofrequency ablation (RFA) is being promoted as a novel technique with low morbidity rate in treatment of inoperable lung tumor either primary lung tumor or metastatic disease. Objective: To report our experiences of RFA treated for lung metastasis in Siriraj Hospital and to evaluate the efficacy and complication of RFA. Material and Method: All patients who underwent RFA for lung metastasis at Siriraj Hospital, between January 2007 and December 2013, were included in the present study. Clinical data, pre-procedure image findings including lesion size, location, post-procedure image findings, complications, and outcome were retrospectively reviewed. Results: Fourteen patients (10 male, 4 female) with 27 lung metastasis were treated with RFA. The ablated lung nodules consist of metastasis from hepatocellular carcinoma (n = 13), colorectal adenocarcinoma (n = 9), insular cell thyroid carcinoma (n = 3), and adenocarcinoma of prostate gland (n = 2). Mean patient age was 50 years (age range 28-67 years). Size of the ablated nodules range from 0.5 to 5.0 cm (median = 1.3 cm). The most common complication was pneumothorax, occurring in 71% (10 of 14 patients). Other complications included surgical site infection, atelectasis, loculated hemothorax, loculated empyema, and bronchopleural fistula, occurred in one patient each. Post-procedure image findings showed complete ablations without local tumor recurrence in 81% (22 of 27 nodules). Local tumor recurrences were seen in 19% (5 of 27 nodules). Conclusion: Radiofrequency ablation for lung metastasis can be considered as a relatively safe, effective alternative treatment for lung metastasis. Risk factors that may associate with local recurrence include large size nodules and subpleural location.