title: Determinants of local progression after computed tomography-guided percutaneous radiofrequency ablation for unresectable lung tumors: 9-year experience in a single institution.
abstract: The purpose of this study was to retrospectively determine the local control rate and contributing factors to local progression after computed tomography (CT)-guided radiofrequency ablation (RFA) for unresectable lung tumor. This study included 138 lung tumors in 72 patients (56 men and 16 women; age 70.0 +/- 11.6 years (range 31-94); mean tumor size 2.1 +/- 1.2 cm [range 0.2-9]) who underwent lung RFA between June 2000 and May 2009. Mean follow-up periods for patients and tumors were 14 and 12 months, respectively. The local progression-free rate and survival rate were calculated to determine the contributing factors to local progression. During follow-up, 44 of 138 (32%) lung tumors showed local progression. The 1-, 2-, 3-, and 5-year overall local control rates were 61, 57, 57, and 38%, respectively. The risk factors for local progression were age (>or=70 years), tumor size (>or=2 cm), sex (male), and no achievement of roll-off during RFA (P < 0.05). Multivariate analysis identified tumor size >or=2 cm as the only independent factor for local progression (P = 0.003). For tumors <2 cm, 17 of 68 (25%) showed local progression, and the 1-, 2-, and 3-year overall local control rates were 77, 73, and 73%, respectively. Multivariate analysis identified that age >or=70 years was an independent determinant of local progression for tumors <2 cm in diameter (P = 0.011). The present study showed that 32% of lung tumors developed local progression after CT-guided RFA. The significant risk factor for local progression after RFA for lung tumors was tumor size >or=2 cm.
authors.affiliation: Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. o-kuma@msic.med.osaka-cu.ac.jp
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Okuma
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Oyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hamamoto
authors.forename: Masami
authors.initials: M
authors.lastname: Toyoshima
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Miki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome