Intraoperative radiofrequency ablation of lung metastases and histologic evaluation.
BACKGROUND
Radiofrequency ablation (RFA) has received high interest in the treatment of primary and secondary lung neoplasms. Clinical experience continues to accumulate; however, the biologic effects after ablation remain poorly understood. This study evaluated the safety and feasibility of RFA in an open thoracotomy setting and investigated the early histopathologic changes after RFA.


METHODS
The study enrolled 18 subjects with multiple pulmonary metastases from a solid primary tumor. RFA was performed at an open thoracotomy setting, followed by wedge resection of the ablated tumor.


RESULTS
No intraoperative complications during the RFA procedure occurred. Immunostaining revealed a complete ablation in 7 patients (39%). The grade of ablation was greater than 90% in 9 patients (50%), and less than 90% in 2 (11%). No correlation was found between the grade of ablation and the applied energy and the diameter of the lesion.


CONCLUSIONS
Intraoperative RFA in an open thoracotomy setting appears to be a safe and feasible technique. Tumor devitalization sufficient for local control was achieved in 89% in our series. Ablation was incomplete in 11%, subject to the methods used in this study. This result appears to be inferior to metastasectomy by surgical resection.
Schneider
Thomas
T
Department of Thoracic Surgery, Thoraxklinik Heidelberg, Heidelberg, Germany.
Warth
Arne
A
Herpel
Esther
E
Schnabel
Philipp A
PA
von Deimling
Andreas
A
Eberhardt
Ralf
R
Herth
Felix J F
FJ
Dienemann
Hendrik
H
Hoffmann
Hans
H
D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007430:Intraoperative Care / Q000379:methods*; D008175:Lung Neoplasms / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D018570:Risk Assessment; D017751:Safety Management; D012680:Sensitivity and Specificity; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome