Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: midterm results in 27 patients

J Vasc Interv Radiol. 2007 Oct;18(10):1264-9. doi: 10.1016/j.jvir.2007.06.027.

Abstract

Purpose: To retrospectively evaluate the midterm outcomes (eg, safety, local efficacy, and survival) after radiofrequency (RF) ablation for pulmonary metastases from colorectal cancer.

Materials and methods: Twenty-seven patients (19 men and eight women; mean age, 61.6 years) with 49 pulmonary metastases (mean long axis diameter, 1.5 cm) from colorectal cancer underwent 41 percutaneous computed tomography (CT)-guided RF ablation sessions. Follow-up examinations were performed with CT by using contrast medium administration in all patients; positron emission tomography was performed in five patients. The safety of the procedure, local tumor control, and patient survival were evaluated. Multiple variables were analyzed to determine prognostic factors.

Results: Pneumothorax occurred after 20 of the 41 sessions (49%), three of which necessitated chest tube placement. A small pleural effusion was found after six of the 41 sessions (15%). No major hemorrhagic event was observed. None of the patients died due to the procedure. The median follow-up period was 20.1 months (range, 11.2-47.7 months). The primary and secondary technique effectiveness rates were 72% and 85%, respectively, at 1 year, 56% and 62% at 2 years, and 56% and 62% at 3 years. The overall survival rates after RF ablation were 96% at 1 year, 54% at 2 years, and 48% at 3 years. The presence of extrapulmonary metastasis was determined to be a prognostic factor (P = .001).

Conclusions: The midterm outcomes of percutaneous RF ablation for colorectal pulmonary metastases appear promising. The presence of extrapulmonary metastasis had an adverse effect on survival after RF ablation.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation* / adverse effects
  • Colorectal Neoplasms / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Patient Selection
  • Pleural Effusion / etiology
  • Pneumothorax / etiology
  • Positron-Emission Tomography
  • Radiography, Interventional
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome