Feasibility of percutaneous radiofrequency ablation for intrathoracic malignancies: a large single-center experience.
BACKGROUND
Radiofrequency ablation (RFA) has become an accepted alternative for treating intrathoracic malignancies; however, the incidence and characteristics of peri- and postprocedural complications are not well described. The purpose of the study was to assess the safety and technical feasibility of percutaneous RFA in unresectable intrathoracic malignancies.


METHODS
Percutaneous RFA was performed in patients with intrathoracic malignancies between June 2001 and December 2004. In total, 366 tumors were treated in 137 patients in 211 sessions. All patients were nonsurgical candidates or had refused surgery. Three hundred and thirty-six lesions were subjected to RFA for the treatment of metastases and 30 lesions for primary lung carcinoma.


RESULTS
Although no procedural mortality occurred, 2 patients died during the course of the study because of intractable pneumothorax and massive hemoptysis (0.9%). The overall major complication rate was 17.1% (pneumothoraces requiring tube drainage in 25, pleuritis in 6, pleural effusion requiring tube drainage in 4, lung abscess in 1, and intrapulmonary hemorrhage with hemothorax in 1). Minor complications included pneumothoraces not requiring tube drainage in 108 sessions, pleural effusion without drainage in 34, hemosputum in 9, nausea and/or vomiting in 3, subcutaneous emphysema in 3, cough in 2, skin burn in 2, atelectasis in 1, and subileus in 1. High fever and/or chest pain were seen in 33.8% and 39.3% of patients, respectively.


CONCLUSIONS
With over 200 procedures, RFA appears to be a safe and minimally invasive option with negligible mortality and little morbidity in selected patients with unresectable intrathoracic malignancies.
Sano
Yoshifumi
Y
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. ysano@md.okayama-u.ac.jp
Kanazawa
Susumu
S
Gobara
Hideo
H
Mukai
Takashi
T
Hiraki
Takao
T
Hase
Soichiro
S
Toyooka
Shinichi
S
Aoe
Motoi
M
Date
Hiroshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome