title: Risk Factors for Local Progression after Percutaneous Radiofrequency Ablation of Lung Tumors: Evaluation Based on a Review of 147 Tumors.
abstract: OBJECTIVE
  To retrospectively evaluate risk factors related to incomplete computed tomography (CT)-guided radiofrequency (RF) ablation of metastatic and primary lung tumors.
  
  
  METHODS
  This study included 93 patients with 147 tumors: 70 men, 23 women; median age 54 y (range, 19-81 y); 24 cases of primary lung tumors, 69 cases of metastases; average largest diameter of tumors, 1.8 cm ± 1.2 (range, 0.3-6.0 cm). Local efficacy was evaluated based on CT follow-up scans. Complete ablation rates (CARs) for tumors were calculated according to several variables; independent risk factors for local tumor progression (LTP) were examined by binary logistic regression analysis.
  
  
  RESULTS
  CAR of tumors was 60.54% within first 6 months after lung RF ablation; median interval of LTP was 1.5 months (mean, 1.3 months ± 1.0; range, 0 days to 3 months). Compared with tumors > 3 cm, CAR of tumors ≤ 3 cm was significantly higher (68.55% vs 17.39%, P < .001). CAR of tumors with complete ablation margin (AM) was dramatically higher compared with tumors with incomplete AM (74.77% vs 16.67%, P < .001). Among tumors with complete AM, CAR of tumors with shortest distance between outer edge of tumor and AM (ablative margin D) ≥ 5 mm was compared with tumors with ablative margin D 1-4 mm (85.96% vs 62.96%, P = .005). Multivariate regression analysis showed that lobulation and/or spicules, contact with blood vessels, and ablative margin D < 5 mm were independent risk factors for incomplete lung RF ablation. LTP was likely to develop at the edge of ablated lesions and especially the site of incomplete AM or shortest AM.
  
  
  CONCLUSIONS
  RF ablation for lung cancers should be individualized based on tumor size, morphology, and tumor type to obtain an adequate AM.
authors.affiliation: Department of Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Qiuxia
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Han
authors.initials: H
authors.lastname: Qi
authors.affiliation: Department of Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wan
authors.affiliation: Department of Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Ze
authors.initials: Z
authors.lastname: Song
authors.affiliation: Department of Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Minimally Invasive Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China. Electronic address: zhaoqianqian2016@sina.com.
authors.forename: Weijun
authors.initials: W
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D017115:Catheter Ablation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D018365:Neoplasm, Residual; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult