Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation.
OBJECTIVE
To prospectively evaluate the local efficacy of radiofrequency (RF) ablation of lung neoplasms, with a minimum follow-up period of 1 year.


METHODS
Sixty patients (34 men and 26 women; age range, 27-81 years; mean age, 66 years) with 100 lung tumors gave written informed consent to be enrolled in a prospective study that was approved by the local ethics committee. There were five or fewer tumors per patient, each with a diameter of less than 40 mm (mean +/- standard deviation, 17 mm +/- 10). RF ablation was performed in tumors by using computed tomographic (CT) guidance. Follow-up CT studies were obtained within 48 hours after treatment and at 2, 4, 6, 9, and 12 months thereafter to evaluate treatment outcome and complications. Lung spirometry measurements were obtained before and 4 weeks after RF ablation.


RESULTS
Ninety-seven of 100 targeted tumors were treated and required 163 RF ablations (1.68 per tumor), each lasting 14 minutes +/- 8, delivered during 74 procedures. The 18-month estimated rate of incomplete local treatment at CT was 7% (95% confidence interval: 3%, 14%) per tumor and 12% (95% confidence interval: 5%, 23%) per patient. An ablation area at least four times larger than the initial tumor was predictive of complete ablation treatment (P = .02). There was a trend toward better efficacy for tumors smaller than 2 cm in diameter (P = .066). Overall survival and lung disease-free survival at 18 months were 71% and 34%, respectively. The main adverse event was a pneumothorax, which occurred in 54% of procedures, but a chest tube was required in only 9% of the procedures. No modification of respiratory function was found when spirometry measurements obtained before and within 2 months after RF ablation were compared (P = .51).


CONCLUSIONS
RF ablation has a high local efficacy and is well tolerated.
de Baère
Thierry
T
Department of Interventional Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France. debaere@igr.fr
Palussière
Jean
J
Aupérin
Anne
A
Hakime
Antoine
A
Abdel-Rehim
Mohamed
M
Kind
Michèle
M
Dromain
Clarisse
C
Ravaud
Alain
A
Tebboune
Nathalie
N
Boige
Valérie
V
Malka
David
D
Lafont
Clarisse
C
Ducreux
Michel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D015641:Radiography, Interventional; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome