title: Radiofrequency ablation of metastatic mediastinal lymph nodes during cooling and temperature monitoring of the tracheal mucosa to prevent thermal tracheal damage: initial experience.
abstract: Institutional review board approval and patient informed consent were obtained. Radiofrequency ablation in a total of 10 sessions was performed for each mediastinal lymph node metastasis from esophageal cancer that had a mean largest diameter of 2.2 cm +/- 0.6 (standard deviation) in seven male patients (mean age, 59 years). During ablation, cooling and temperature of the tracheal mucosa were monitored in the proper position in eight of the 10 sessions; in the other two sessions, monitoring was not done because of tracheal stenosis (perforation resulted). Three of the four lymph nodes that were 2.0 cm or smaller in largest diameter showed no evidence of local progression for at least 1 year since ablation; all three of the nodes greater than 2.0 cm in largest diameter progressed within 6 months. The 1-year survival rate was 60%; the median survival time was 13 months. Radiofrequency ablation may be effective for local control of small metastatic mediastinal lymph nodes, and cooling and temperature monitoring of the tracheal mucosa in the proper position may prevent thermal tracheal damage.
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan. takaoh@tc4.so-net.ne.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Hiraki
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yasui
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Mimura
authors.forename: Hideo
authors.initials: H
authors.lastname: Gobara
authors.forename: Takashi
authors.initials: T
authors.lastname: Mukai
authors.forename: Soichiro
authors.initials: S
authors.lastname: Hase
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Tajiri
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naomoto
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yamatsuji
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shirakawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Asami
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Motohiko
authors.initials: M
authors.lastname: Hanazaki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Susumu
authors.initials: S
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D003287:Contrast Media; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009092:Mucous Membrane / Q000473:pathology; D011183:Postoperative Complications; D013696:Temperature; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media