Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device

This study aimed to assess the feasibility and short-term results for percutaneous radiofrequency ablation in the treatment of primary and secondary lung tumors.

Between May 2003 and July 2004, 15 patients (mean age, 64.9 years; range, 51–80 years) with 18 pulmonary lesions (9 primitive non–small cell lung cancers and 9 metastases) underwent the ablation procedure. All the patients had absolute contraindications to the surgery. The procedure was performed under computed tomography (CT) guidance with anesthesiologic assistance using a coaxial Le Veen needle electrode. The results were evaluated by postprocedural CT scan, and then by clinical and laboratory examination and CT scan 1, 3, 6, 9, and 12 months after the treatment.

A complete ablation was obtained for 16 of 18 lesions (88.9%), and a partial ablation was achieved for the remaining 2 lesions (central tumors). In terms of complications, there were five cases of pneumothorax (2 resolved spontaneously and 3 were drained through a coaxial needle), four middle pleural reactions, and one hemothorax that required draining surgically. Follow-up evaluation was performed for 16 of 18 lesions. Stability was observed in one of two central tumors that received partial ablation. The remaining 15 tumors that received a complete ablation were followed up for a mean of 5 months (range, 1–12 months). All 15 lesions appeared to be hypodense at the CT examination. Dimension reduction with progressive fibrotic scar formation was observed in seven of seven lesions during a follow-up period of 6 months or more. A recurrence at the site of the treatment for two of three lesions was observed during a 12-month follow-up period. One of these received a second radiofrequency ablation. Five patients experienced systemic disease progression. In four of these five patients, this progression was not associated with recurrence at the site of the treatment.

Radiofrequency ablation seems to be possible for “nonsurgical” patients with primary and secondary lung tumors. Good results in terms of local tumor control were observed during short-term follow-up evaluation.