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Comparative Study
. 2014 Jul;25(7):989-96.
doi: 10.1016/j.jvir.2014.02.021. Epub 2014 Apr 2.

Radiofrequency ablation of T1 lung carcinoma: comparison of outcomes for first primary, metachronous, and synchronous lung tumors

Carole A Ridge  1 , Mikhail Silk  2 , Elena N Petre  3 , Joseph P Erinjeri  3 , William Alago  3 , Robert J Downey  4 , Constantinos T Sofocleous  3 , Raymond H Thornton  3 , Stephen B Solomon  3
Affiliations
Comparative Study

Radiofrequency ablation of T1 lung carcinoma: comparison of outcomes for first primary, metachronous, and synchronous lung tumors

Carole A Ridge et al. J Vasc Interv Radiol. 2014 Jul.

Abstract

Purpose: To report and compare outcomes after radiofrequency ablation for treatment-naïve first primary, metachronous, and synchronous T1 lung tumors.

Materials and methods: This institutional review board-approved retrospective study reviewed 29 patients (12 men and 17 women; median age, 73 y; age range, 55-86 y) with treatment-naïve T1 lung tumors treated with radiofrequency ablation. Tumors in the 29 patients included 21 T1a and 8 T1b first primary (n = 11), metachronous (n = 14), or synchronous (n = 4) tumors (adenocarcinoma, n = 25; squamous cell carcinoma, n = 3; unspecified, n = 1). Median tumor diameter was 14 mm (range, 10-26 mm). Surveillance computed tomography or positron emission tomography-computed tomography was performed over a median period of 28 months (range, 12-83 mo). Technical success and effectiveness rates and overall and progression-free 1-year, 3-year, and 5-year survivals were calculated according to stage, first primary, metachronous, and synchronous tumor status.

Results: Technical success and effectiveness was 97%. Local control occurred in 17 of 21 T1a tumors (81%) and 5 of 8 T1b tumors (62.5%). The local progression rate of first primary tumors (5 of 11; 45%) was higher than that of metachronous (2 of 14; 14%; P = .07) and synchronous (0 of 4; P = .01) tumors. Estimated 1-year, 3-year, and 5-year local tumor progression-free survival was 79%, 75%, and 75%. Estimated 1-year, 3-year, and 5-year overall survival was 100%, 60%, and 14%. Survival outcomes were similar for patients with first primary, metachronous, or synchronous tumors.

Conclusions: Radiofrequency ablation results in good local control and progression-free survival in patients with treatment-naïve T1 lung tumors, including patients with metachronous and synchronous tumors.

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Conflict of interest statement

None of the authors have identified a conflict of interest.

Figures

Figure 1.
Figure 1.
RF ablation technique. A 62-year-old patient with a left lower lobe ground-glass opacity (a), confirmed histologically to be adenocarcinoma, underwent RF ablation using a single 3-cm exposed tip probe (b). Perilesional ground-glass opacity and lesional increased density are observed immediately after the procedure (c), and the typical perilesional concentric rings of varying density, often referred to as the “cockade phenomenon,” are observed on CT scan 1 month after the procedure (d).
Figure 2.
Figure 2.
Patterns of lung tumor progression by location (11 of 29 patients experienced progression). Regional progression includes intrapulmonary and nodal sites of disease progression.
Figure 3.
Figure 3.
Kaplan-Meier curve representing survival by stage.
Figure 4.
Figure 4.
Kaplan-Meier curve representing survival by tumor chronology.
See this image and copyright information in PMC

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