Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up.
BACKGROUND
We assessed the safety and evidence of efficacy of radiofrequency ablation (RFA) for colorectal lung metastases with follow-up to 1 year.


METHODS
Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-computed tomography (CT). Patients received intravenous conscious sedation and local analgesia with routine hospitalization and monitoring for 24 hours after RFA. Patients had CT scanning at 1 month and then every 3 months, with serum carcinoembryonic antigen assessment monthly and every 3 months.


RESULTS
All ablations were technically successful. Tumor diameter ranged from.3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, four for new lesions and two for re-treatment of a previously treated lesion. The median admission was 2.0 days (range, 1-9 days). The median follow-up was 428 days (range, 173-829 days); data are reported to 1 year in this article. Five patients died at 5, 6, 8, 8, and 12 months after RFA from extrapulmonary (n = 1) or widespread (n = 4) disease. One patient developed a malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%); all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at 1 year have 40 lesions classified as disappeared (n = 17), decreased (n = 5), stable/same size (n = 4), or increased (n = 14).


CONCLUSIONS
Percutaneous imaging-guided RFA of multiple colorectal pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at 1 year.
Steinke
Karin
K
University of New South Wales, Departments of Surgery (KS, JK, JZ, DM), Radiology (DG, WC), and Medical Oncology (PC), The St. George Hospital, Sydney, New South Wales, Australia.
Glenn
Derek
D
King
Julie
J
Clark
William
W
Zhao
Jing
J
Clingan
Phillip
P
Morris
David L
DL
D000328:Adult; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen