title: Pulmonary radiofrequency ablation in a district general hospital: is it a safe and effective treatment?
abstract: OBJECTIVE
  To analyse the technical success of ablation therapy and the incidence of complications in patients treated with pulmonary ablation and to assess factors affecting local disease control and patient survival in a subgroup with metastatic colorectal cancer.
  
  
  METHODS
  Technical success and complications in all patients undergoing lung ablation between June 2009 and July 2015 were recorded. Overall survival and local disease control in a subgroup with metastases from a colorectal primary were calculated. Factors influencing outcome were explored.
  
  
  RESULTS
  Two hundred and seven pulmonary ablations were performed in 86 patients at 156 attendances. Technical success was achieved in 207/207 (100%). Thirty and 90-day mortality was 0%. The major complication rate was 13/86 (15%). One hundred and one metastases were treated in 46 patients with a colorectal primary. This group had a mean ± standard error survival time of 53.58±3.47 months with a 1, 2, 3, 4, and 5-year survival rate of 97.4%, 91.3%, 81.5%, 59.8%, and 48%. There was no statistically significant difference in survival regarding time to development of metastatic disease, the total number of lesions ablated, the initial number of lesions ablated, the maximum size of lesion treated, or unilateral versus bilateral disease. Patients with extrapulmonary disease were found to have a shorter survival from the primary diagnosis. Seventy-eight (77.2%) of the 101 lesions were stable after first RFA. Local relapse was more likely when a metastasis was close to a large (>3 mm) vessel.
  
  
  CONCLUSIONS
  RFA is a safe and effective procedure that can be performed without on-site cardiothoracic support. Good outcomes depend upon careful patient selection. This study supports its use in oligometastatic disease.
authors.affiliation: Department of Radiology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK. Electronic address: simon.smith@ipswichhospital.nhs.uk.
authors.forename: S L
authors.initials: SL
authors.lastname: Smith
authors.affiliation: Department of Science and Technology, University Campus Suffolk, Neptune Quay, Ipswich, Suffolk IP4 1QJ, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bowers
authors.affiliation: Department of Radiology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK.
authors.forename: P
authors.initials: P
authors.lastname: Jennings
authors.affiliation: Department of Oncology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK.
authors.forename: R
authors.initials: R
authors.lastname: Soomal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000401:mortality* / Q000706:statistics & numerical data; D006767:Hospitals, District / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality*; D013510:Pulmonary Surgical Procedures / Q000401:mortality* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology