Radiofrequency Ablation of Lung Metastasis Not Suitable
for Surgery: Experience in Siriraj Hospital
Trongtum Tongdee MD*,
Pattama Tantigate MD*, Ranista Tongdee MD*
Affiliation :
* Department of Diagnostic Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Percutaneous image-guided radiofrequency ablation (RFA) is being promoted as a novel technique with low
morbidity rate in treatment of inoperable lung tumor either primary lung tumor or metastatic disease.
Objective : To report our experiences of RFA treated for lung metastasis in Siriraj Hospital and to evaluate the efficacy and
complication of RFA.
Material and Method: All patients who underwent RFA for lung metastasis at Siriraj Hospital, between January 2007 and
December 2013, were included in the present study. Clinical data, pre-procedure image findings including lesion size,
location, post-procedure image findings, complications, and outcome were retrospectively reviewed.
Results : Fourteen patients (10 male, 4 female) with 27 lung metastasis were treated with RFA. The ablated lung nodules
consist of metastasis from hepatocellular carcinoma (n = 13), colorectal adenocarcinoma (n = 9), insular cell thyroid
carcinoma (n = 3), and adenocarcinoma of prostate gland (n = 2). Mean patient age was 50 years (age range 28-67 years).
Size of the ablated nodules range from 0.5 to 5.0 cm (median = 1.3 cm). The most common complication was pneumothorax,
occurring in 71% (10 of 14 patients). Other complications included surgical site infection, atelectasis, loculated hemothorax,
loculated empyema, and bronchopleural fistula, occurred in one patient each. Post-procedure image findings showed
complete ablations without local tumor recurrence in 81% (22 of 27 nodules). Local tumor recurrences were seen in 19%
(5 of 27 nodules).
Conclusion : Radiofrequency ablation for lung metastasis can be considered as a relatively safe, effective alternative treatment
for lung metastasis. Risk factors that may associate with local recurrence include large size nodules and subpleural location.
Keywords : RFA, Radiofrequency ablation, Lung metastasis
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