Efficacy and safety of percutaneous radiofrequency thermal ablation in the treatment of lung cancer lesions.

Tavares e Castro, A; Freitas, S; Portilha, A; Alves, F; Caseiro-Alves, F

http://hdl.handle.net/10400.4/1872

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INTRODUCTION: In this study, we reviewed a clinical series composed by all malignant lung lesions submitted to computed tomography-guided percutaneous thermal radiofrequency ablation, in our hospital, a rather recent technique that has been gaining scientific recognition. MATERIAL AND METHODS: For data purposes, all radiofrequency ablation and corresponding clinical records were retrospectively analysed. A computed tomography scan was performed before and after each procedure to evaluate the tumour's features, and at a second step to assess results and complications. The frequency of local recurrence and disease progression were determined based on imaging follow-up. Kaplan-Meier analysis was used to estimate survival. Univariate analysis recognized clinical and pathological factors affecting survival. These were also tested by multivariate analysis. RESULTS: A total of 28 malignant lung lesions, 20 primary and 8 metastatic, from 28 patients (78.6% male; mean age 62 ± 17 years old), were submitted to computed tomography-guided radiofrequency ablation between January 2004 and July 2010. Total necrosis was achieved in 74.1% of the lesions. Immediate radiofrequency ablation-related complications were observed in half of the procedures. Among major complications, death occurred in one patient only. Median overall survival was 43.0 months for a mean 2-years follow-up.Median progression-free survival was 31.6 months. Lesion's size smaller than 35 mm, stage III disease by the TNM classification and previous treatment attempts were significantly associated with better outcomes. Disease-related mortality was 46.4%. DISCUSSION: This procedure proved to be efficient to treat lung cancerous lesions, with a low-rate of major complications. CONCLUSIONS: Computed tomography-guided percutaneous radiofrequency ablation is a minimally invasive procedure that appears to be valuable in the treatment of lung cancer lesions.