Abstract
Background
Radiofrequency ablation (RFA) has been increasingly utilized as a non-surgical treatment option for patients with primary and metastatic lung tumors. We performed the present systematic review to assess the safety and efficacy of RFA.
Methods
Searches for all relevant studies prior to November 2006 were performed on six databases. Two reviewers independently appraised each study using predetermined criteria. Clinical effectiveness was synthesized through a narrative review, with full tabulation of results of all included studies.
Results
A total of 17 of the most recent updates from each institution were included for appraisal and data extraction. All were case series and were classified as level-4 evidence. The mean number of lesions treated ranged from 1 to 2.8, and the mean size ranged from 1.7 cm to 5.2 cm. The overall procedure-related morbidity rate ranged from 15.2% to 55.6% and mortality from 0% to 5.6%. The most commonly reported complication was pneumothorax (4.5–61.1%). Most pneumothoraces were self-limiting and only 3.3–38.9% (median = 11%) required chest drain insertion. The local recurrence of tumors at the site of RFA ranged from 3% to 38.1% (median = 11.2%). The median progression-free interval ranged from 15 months to 26.7 months (median = 21 months), and 1-, 2- and 3-year survival rates were 63–85%, 55–65% and 15–46%, respectively.
Conclusions
Only observational studies were available for evaluation, which demonstrated some promising safety profiles of RFA.
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Reference
Jemal A, Siegel R, Ward E et al. Cancer statistics, 2007. CA Cancer J Clin 2007; 57:43–66
Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000; 38:453–70
Dienemann H. Principles of surgical treatment in localized non-small cell lung cancer. Lung Cancer 2001; 33 Suppl 1 :S3–8
Hoffman PC, Mauer AM, Vokes EE. Lung cancer. Lancet 2000; 355:479–85
Pearson FG. Current status of surgical resection for lung cancer. Chest 1994; 106:337S–9S
Licker M, Spiliopoulos A, Frey JG et al. Risk factors for early mortality and major complications following pneumonectomy for non-small cell carcinoma of the lung. Chest 2002; 121:1890–7
Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg 1997; 113: 37–49
Sutherland LM, Williams JA, Padbury RT et al. Radiofrequency ablation of liver tumors: a systematic review. Arch Surg 2006; 141:181–90
Lencioni R, Della Pina C, Bartolozzi C. Percutaneous image-guided radiofrequency ablation in the therapeutic management of hepatocellular carcinoma. Abdom Imaging 2005; 30:401–8
Dupuy DE, Goldberg SN. Image-guided radiofrequency tumor ablation: challenges and opportunities–part II. J Vasc Interv Radiol 2001; 12:1135–48
Ahmed M, Liu Z, Afzal KS et al. Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model. Radiology 2004; 230:761–7
Dupuy DE, Zagoria RJ, Akerley W et al. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 2000; 174:57–9
Nishida T, Inoue K, Kawata Y et al. Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 2002; 195:426–30
Herrera LJ, Fernando HC, Perry Y et al. Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 2003; 125:929–37
Fernando HC, De Hoyos A, Landreneau RJ et al. Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 2005; 129:639–44
King J, Glenn D, Clark W et al. Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer. Br J Surg 2004; 91:217–23
Steinke K, Glenn D, King J et al. Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up. Ann Surg Oncol 2004; 11:207–12
Yan TD, King J, Sjarif A et al. Learning curve for percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: a prospective study of 70 consecutive cases. Ann Surg Oncol 2006; 13:1588–95
Yan TD, King J, Sjarif A et al. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol 2006; 13:1529–37
Suh RD, Wallace AB, Sheehan RE et al. Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation–preliminary results. Radiology 2003; 229:821–9
Lee JM, Jin GY, Goldberg SN et al. Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 2004; 230:125–34
Akeboshi M, Yamakado K, Nakatsuka A et al. Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 2004; 15:463–70
Yasui K, Kanazawa S, Sano Y et al. Thoracic tumors treated with CT-guided radiofrequency ablation: initial experience. Radiology 2004; 231:850–7
Gadaleta C, Mattioli V, Colucci G et al. Radiofrequency ablation of 40 lung neoplasms: preliminary results. AJR Am J Roentgenol 2004; 183:361–8
Gadaleta C, Catino A, Ranieri G et al. Radiofrequency Thermal Ablation of 69 Lung Neoplasms. J Chemother 2004; 16:86–9
Kang S, Luo R, Liao W et al. Single group study to evaluate the feasibility and complications of radiofrequency ablation and usefulness of post treatment position emission tomography in lung tumours. World J Surg Oncol 2004; 2:30
Belfiore G, Moggio G, Tedeschi E et al. CT-guided radiofrequency ablation: a potential complementary therapy for patients with unresectable primary lung cancer–a preliminary report of 33 patients. AJR Am J Roentgenol 2004; 183:1003–11
Belfiore G, Tedeschi E, Brillantino C et al. Palliation of Unresectable Lung Cancer with CT-guided Radiofrequency Ablation: Clinical and Imaging Findings at One-year. Int J Clin Invest 2006; 2:35–40
VanSonnenberg E, Shankar S, Morrison PR et al. Radiofrequency ablation of thoracic lesions: part 2, initial clinical experience–technical and multidisciplinary considerations in 30 patients. AJR Am J Roentgenol 2005; 184:381–90
Kishi K, Nakamura H, Kobayashi K et al. Percutaneous CT-guided radiofrequency ablation of pulmonary malignant tumors: preliminary report. Intern Med 2006; 45:65–72
Rossi S, Dore R, Cascina A et al. Percutaneous computed tomography-guided radiofrequency thermal ablation of small unresectable lung tumours. Eur Respir J 2006; 27:556–63
Ambrogi MC, Lucchi M, Dini P et al. Percutaneous radiofrequency ablation of lung tumours: results in the mid-term. Eur J Cardiothorac Surg 2006; 30:177–83
Lagana D, Carrafiello G, Mangini M et al. Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device. Surg Endosc 2006; 20:1262–7
de Baere T, Palussiere J, Auperin A et al. Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 2006; 240:587–96
Hiraki T, Tajiri N, Mimura H et al. Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: incidence and risk factors. Radiology 2006; 241:275–83
Thanos L, Mylona S, Pomoni M et al. Percutaneous radiofrequency thermal ablation of primary and metastatic lung tumors. Eur J Cardiothorac Surg 2006; 30:797–800
CEBM. Oxford Center for Evidence-Based Medicine: The levels of evidence 2001. http://www.cebm.net/index.aspx?o=1025 [accessed December 28, 2007]
Rowell NP, Williams CJ. Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable). Cochrane Database Syst Rev 2001; CD002935
Rowell NP, O’Rourke NP. Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev 2004; CD002140
Girard P, Baldeyrou P, Le Chevalier T et al. Surgery for pulmonary metastases. Who are the 10-year survivors? Cancer 1994; 74:2791–7
Best L, Simmonds P, Baughan C et al. Palliative chemotherapy for advanced or metastatic colorectal cancer. Colorectal Meta-analysis Collaboration. Cochrane Database Syst Rev 2002; CD001545
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Zhu, J.C., Yan, T.D. & Morris, D.L. A Systematic Review of Radiofrequency Ablation for Lung Tumors. Ann Surg Oncol 15, 1765–1774 (2008). https://doi.org/10.1245/s10434-008-9848-7
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DOI: https://doi.org/10.1245/s10434-008-9848-7