Radiofrequency ablation of metastatic mediastinal lymph nodes during cooling and temperature monitoring of the tracheal mucosa to prevent thermal tracheal damage: initial experience.
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.
Hiraki
Takao
T
Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan. takaoh@tc4.so-net.ne.jp
Yasui
Kotaro
K
Mimura
Hidefumi
H
Gobara
Hideo
H
Mukai
Takashi
T
Hase
Soichiro
S
Fujiwara
Hiroyasu
H
Tajiri
Nobuhisa
N
Naomoto
Yoshio
Y
Yamatsuji
Tomoki
T
Shirakawa
Yasuhiro
Y
Asami
Shinya
S
Nakatsuka
Hideki
H
Hanazaki
Motohiko
M
Morita
Kiyoshi
K
Tanaka
Noriaki
N
Kanazawa
Susumu
S
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
D003287:Contrast Media