title: Vacuum-assisted resection of malignant tumors with and without subsequent radiofrequency ablation: feasibility of complete tumor treatment tested in an animal model.
abstract: OBJECTIVE
  To evaluate the feasibility of vacuum-assisted tumor excision with and without RF ablation for the minimally invasive treatment of small tumors.
  
  
  METHODS
  Twenty VX2 tumors were implanted bilaterally into the spine muscle of 10 rabbits. Tumor excision was performed after tumor sizes reached 10 mm (12-27 d incubation) with use of a vacuum-assisted biopsy device. Three or four directed vacuum-assisted biopsies were performed in angle steps of 30 degrees. In 10 tumors, ultrasound (US)-guided radiofrequency (RF) ablation (8 min, 60 W) was subsequently performed with use of a cooled-tip electrode system. Follow-up US was performed at 3-4-day intervals for as long as 3 weeks after excision/RF ablation. Autopsy and histopathologic analysis were performed.
  
  
  RESULTS
  The duration of vacuum excision ranged from 12 to 45 minutes (25 min +/- 7). Histologically tumor-free margins in the outer round of the core biopsy specimens were found in only four of 20 cases (20%). Maximum lesion sizes during RF ablation ranged from 18 to 25 mm (20 mm +/- 2.6). Histologic examination of the excision specimens documented tumor-free margins in only three tumors (30%) among the excision-only group and only one (10%) among the combined excision/ablation group. Local recurrences occurred in eight of 10 cases (80%) after vacuum excision alone, whereas recurrence after combined excision and RF ablation occurred only in two of 10 cases (20%; P <.05).
  
  
  CONCLUSIONS
  Local tumor resection with use of vacuum-assisted biopsy is feasible and promising as a minimally invasive therapy for the treatment of small focal breast neoplasms. Combined excision and RF ablation techniques may reduce the rate of local recurrence considerably.
authors.affiliation: Department of Medical Radiology, Institut für Diagnostische Radiologie, Universitätsspital Zürich, Switzerland. thomas_boehm@gmx.net
authors.forename: T
authors.initials: T
authors.lastname: Boehm
authors.forename: A
authors.initials: A
authors.lastname: Malich
authors.forename: S
authors.initials: S
authors.lastname: Nahum Goldberg
authors.forename: J R
authors.initials: JR
authors.lastname: Reichenbach
authors.forename: I
authors.initials: I
authors.lastname: Hilger
authors.forename: M
authors.initials: M
authors.lastname: Fleck
authors.forename: W A
authors.initials: WA
authors.lastname: Kaiser
mesh_terms: D000818:Animals; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D004195:Disease Models, Animal; D004867:Equipment Design; D005240:Feasibility Studies; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D009374:Neoplasms, Experimental / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011817:Rabbits; D014463:Ultrasonography