title: Unresectable Adrenal Metastases: Clinical Outcomes of Radiofrequency Ablation.
abstract: OBJECTIVE
  To retrospectively evaluate the clinical outcomes of radiofrequency (RF) ablation for the treatment of unresectable adrenal metastasis.
  
  
  METHODS
  The institutional review board approved this retrospective study, and informed consent to perform adrenal RF ablation was obtained from all patients. From February 2005 through May 2014, 35 patients (25 men and 10 women; mean age, 64.7 years ± 9.6; age range, 39-82 years) underwent RF ablation to treat 41 metastatic adrenal tumors from lung cancer (n = 15), renal cell carcinoma (n = 9), colorectal cancer (n = 5), hepatocellular carcinoma (n = 4), and other tumors (n = 2). Tumors ranged in size from 1.2 to 8.2 cm (mean, 3.3 cm ± 1.6). The diagnosis was established mainly on the basis of radiologic findings. Adrenal arterial embolization was combined with RF ablation in 12 of the 35 patients (34%). Technical success, safety, local tumor progression, and survival were evaluated. The Kaplan-Meier method and Cox proportional hazard model were used to evaluate prognostic factors.
  
  
  RESULTS
  There were 48 completed sessions with planned procedures and treatment protocols with no mortality and a major complication rate of 8.3% (four of 48 sessions). Tumor enhancement disappeared after initial adrenal RF ablation in 33 of the 35 patients (94%). Local tumor progression developed in eight of the 35 patients (23%); two patients received repeated RF ablation, resulting in adrenal tumor control in 27 of the 35 patients (77%) at the last follow-up (mean, 30.1 months ± 27.5; range 1.2-96.8 months). The 1-, 3-, and 5-year overall survival rates were 75% (95% confidence interval [CI], 61%, 90%), 34% (95% CI: 17%, 52%), and 30% (95% CI: 13%, 48%), respectively, with a median survival time of 26.0 months. Existence of extra-adrenal tumors (P = .005) and age of 65 years or older (P = .04) were significant indicators of a poor prognosis.
  
  
  CONCLUSIONS
  Adrenal RF ablation is a feasible and useful method for controlling adrenal metastases and offers patients opportunities for improved survival.
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Uraki
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujimori
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Miki
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakuma
authors.affiliation: From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sugimura
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media