Radiofrequency ablation of T1 lung carcinoma: comparison of outcomes for first primary, metachronous, and synchronous lung tumors.
OBJECTIVE
To report and compare outcomes after radiofrequency ablation for treatment-naïve first primary, metachronous, and synchronous T1 lung tumors.


METHODS
This institutional review board-approved retrospective study reviewed 29 patients (12 men and 17 women; median age, 73 y; age range, 55-86 y) with treatment-naïve T1 lung tumors treated with radiofrequency ablation. Tumors in the 29 patients included 21 T1a and 8 T1b first primary (n = 11), metachronous (n = 14), or synchronous (n = 4) tumors (adenocarcinoma, n = 25; squamous cell carcinoma, n = 3; unspecified, n = 1). Median tumor diameter was 14 mm (range, 10-26 mm). Surveillance computed tomography or positron emission tomography-computed tomography was performed over a median period of 28 months (range, 12-83 mo). Technical success and effectiveness rates and overall and progression-free 1-year, 3-year, and 5-year survivals were calculated according to stage, first primary, metachronous, and synchronous tumor status.


RESULTS
Technical success and effectiveness was 97%. Local control occurred in 17 of 21 T1a tumors (81%) and 5 of 8 T1b tumors (62.5%). The local progression rate of first primary tumors (5 of 11; 45%) was higher than that of metachronous (2 of 14; 14%; P = .07) and synchronous (0 of 4; P = .01) tumors. Estimated 1-year, 3-year, and 5-year local tumor progression-free survival was 79%, 75%, and 75%. Estimated 1-year, 3-year, and 5-year overall survival was 100%, 60%, and 14%. Survival outcomes were similar for patients with first primary, metachronous, or synchronous tumors.


CONCLUSIONS
Radiofrequency ablation results in good local control and progression-free survival in patients with treatment-naïve T1 lung tumors, including patients with metachronous and synchronous tumors.
Department of Radiology, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland. Electronic address: cridge@mater.ie.
Carole A
CA
Ridge
SUNY Downstate Medical Center, Brooklyn, New York.
Mikhail
M
Silk
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Elena N
EN
Petre
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Joseph P
JP
Erinjeri
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
William
W
Alago
Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Robert J
RJ
Downey
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Constantinos T
CT
Sofocleous
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Raymond H
RH
Thornton
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Stephen B
SB
Solomon
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D016609:Neoplasms, Second Primary; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome