Radiofrequency ablation of small lung metastases by a single application of a 2-cm expandable electrode: determination of favorable responders.
OBJECTIVE
To determine which lung metastases are most likely to be treated effectively with a single radiofrequency (RF) application (defined as two separate applications of RF energy at a single electrode position) with a multitined expandable electrode with arrays 2 cm in diameter.


METHODS
The authors retrospectively evaluated 88 lung metastases (mean long-axis diameter, 0.9 cm) in 36 patients (20 men and 16 women; mean age, 57 years) treated with a single RF application with a multitined expandable electrode with arrays 2 cm in diameter. Based on follow-up computed tomographic examinations, the technique effectiveness rates were estimated with Kaplan-Meier analysis. Multiple variables were analyzed with the log-rank test to determine risk factors for local progression. Then, the technique effectiveness rates were again estimated when considering only metastases without risk factors and compared with those of other tumors.


RESULTS
The median follow-up period was 13.2 months (range, 6.0-24.7 months). Tumor size greater than 1.0 cm (P = .033) and contact with the bronchus with an inner diameter of at least 2 mm (P = .047) were the significant risk factors for local progression. The technique effectiveness rates for metastases 1.0 cm or smaller that were not in contact with the bronchus (n = 59) were 96% at 1 year and at 2 years; those rates were significantly (P = .010) higher than those in other tumors (n = 29).


CONCLUSIONS
A single RF application with a multitined expandable electrode with arrays 2 cm in diameter is most likely to suffice in small (<or=1 cm) lung metastases not in contact with a bronchus.
Sakurai
Jun
J
Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan. sakurai@cc.okayama-u.ac.jp
Hiraki
Takao
T
Mimura
Hidefumi
H
Gobara
Hideo
H
Fujiwara
Hiroyasu
H
Tajiri
Nobuhisa
N
Sano
Yoshifumi
Y
Kanazawa
Susumu
S
D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome