Risk factors for local tumor progression after RFA of pulmonary metastases: a matched case-control study.
Ablation
Local tumor progression
Lung
Metastases
Recurrence
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
21
09
2020
accepted:
28
12
2020
revised:
22
11
2020
pubmed:
22
1
2021
medline:
24
6
2021
entrez:
21
1
2021
Statut:
ppublish
Résumé
Curative treatment of oligometastatic pulmonary disease aims at eradication of all metastases. Radiofrequency ablation (RFA) has been shown to be an efficient method and the frequency of local tumor progression (LTP) should be minimized. The objective of this study was to determine the morphological and treatment-related risk factors for LTP after RFA of pulmonary metastases. All patients treated with RFA for pulmonary metastases from 2002 to 2014 were reviewed. All LTPs from 2011 to 2014 were individually matched on the basis of tumor size, number, and histology. In total, 48 LTPs and 112 controls were blindly analyzed for morphological factors including vicinity of bronchus and vessels as well as treatment-related factors such as the size of the ablation zone and ablation margins. In the simple regression analysis, the significant predictive variables were ≤ 5-mm distance to a large bronchus (OR = 4.94; p = 0.0095) or large vessel (OR = 7.09; p < 0.001), minimal ablation margin (≤ 5 mm (OR = 42.67; p < 0.001), and a central-peripheral ablation offset/ablation zone size > 0.36 (OR = 13.83; p = 0.013). In the multiple regression model, only a minimal ablation margin ≤ 5 mm remained a significant risk factor for LTP. Only the minimal ablation margin remains significant in the multiple regression analysis; the other factors are presumably surrogates of an insufficient ablation margin. Improvement of lung RFA outcomes can probably be obtained by immediate post RFA evaluation of ablation margins to ensure a minimal ablation margin of at least 5 mm. • A distance < 5 mm to a bronchus or vessel of over 3 mm diameter is associated with insufficient ablation margin and thus risk factors for local tumor progression after pulmonary radiofrequency ablation. • A minimal ablation margin of > 5 mm after pulmonary RFA is associated with significantly less local tumor progression and should be looked for at the end of treatment session before needle removal in order to decrease local tumor progression. • Tumor location, pleural contact, occurrence of intra-alveolar hemorrhage, pulmonary atelectasis, and pneumothorax are not associated with an increased risk of local tumor progression.
Identifiants
pubmed: 33474569
doi: 10.1007/s00330-020-07675-y
pii: 10.1007/s00330-020-07675-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5361-5369Références
Casiraghi M, De Pas T, Maisonneuve P et al (2011) A 10-year single-center experience on 708 lung metastasectomies: the evidence of the “international registry of lung metastases”. J Thorac Oncol 6(8):1373–1378
doi: 10.1097/JTO.0b013e3182208e58
Niibe Y, Hayakawa K (2010) Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol 40(2):107–111
doi: 10.1093/jjco/hyp167
McGahan JP, Browning PD, Brock JM et al (1990) Hepatic ablation using radiofrequency electrocautery. Invest Radiol 25(3):267–270
doi: 10.1097/00004424-199003000-00011
de Baère T, Palussière J, Aupérin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology. 240(2):587–596
doi: 10.1148/radiol.2402050807
Yin X, Cui L, Li F et al (2015) Radiofrequency ablation versus partial nephrectomy in treating small renal tumors: a systematic review and meta-analysis. Medicine (Baltimore) 94(50):e2255
doi: 10.1097/MD.0000000000002255
Abboud S, Kosmas C, Novak R et al (2016) Long-term clinical outcomes of dual-cycle radiofrequency ablation technique for treatment of osteoid osteoma. Skeletal Radiol 45(5):599–606
doi: 10.1007/s00256-015-2321-3
de Baère T, Aupérin A, Deschamps F et al (2015) Radiofrequency ablation is a valid treatment option for lung metastases: experience in 566 patients with 1037 metastases. Ann Oncol 26(5):987–991
doi: 10.1093/annonc/mdv037
Gonzalez M, Poncet A, Combescure C et al (2013) Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol 20(2):572–579
doi: 10.1245/s10434-012-2726-3
Gadaleta C, Mattioli V, Colucci G et al (2004) Radiofrequency ablation of 40 lung neoplasms: preliminary results. AJR Am J Roentgenol 183(2):361–368
doi: 10.2214/ajr.183.2.1830361
Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113(1):37–49
doi: 10.1016/S0022-5223(97)70397-0
Hatime M, Elmorabit B, Elkhoti Y et al (2012) Oligometastatic disease, a new concept: stereotactic irradiation for lung metastases. Literature review. Cancer Radiother 16(5-6):351–357
doi: 10.1016/j.canrad.2012.07.184
Iida T, Nomori H, Shiba M et al (2013) Prognostic factors after pulmonary metastasectomy for colorectal cancer and rationale for determining surgical indications: a retrospective analysis. Ann Surg 257(6):1059–1064
doi: 10.1097/SLA.0b013e31826eda3b
Chua TC, Sarkar A, Saxena A et al (2010) Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients. Ann Oncol 21(10):2017–2022
doi: 10.1093/annonc/mdq098
Gillams A, Khan Z, Osborn P et al (2013) Survival after radiofrequency ablation in 122 patients with inoperable colorectal lung metastases. Cardiovasc Intervent Radiol 36(3):724–730
doi: 10.1007/s00270-012-0500-3
Hamada A, Yamakado K, Nakatsuka A et al (2012) Radiofrequency ablation for colorectal liver metastases: prognostic factors in non-surgical candidates. Jpn J Radiol 30(7):567–574
doi: 10.1007/s11604-012-0089-0
Yamamoto A, Nakamura K, Matsuoka T et al (2005) Radiofrequency ablation in a porcine lung model: correlation between CT and histopathologic findings. AJR Am J Roentgenol 185(5):1299–1306
doi: 10.2214/AJR.04.0968
Cheang S, Abtin F, Guteirrez A, Genshaft S, Suh R (2013) Imaging features following thermal ablation of lung malignancies. Semin Interv Radiol 30(2):157–168
doi: 10.1055/s-0033-1342957
Okuma T, Matsuoka T, Yamamoto A et al (2010) Determinants of local progression after computed tomography-guided percutaneous radiofrequency ablation for unresectable lung tumors: 9-year experience in a single institution. Cardiovasc Intervent Radiol 33(4):787–793
doi: 10.1007/s00270-009-9770-9
Yamagami T, Kato T, Hirota T et al (2007) Risk factors for occurrence of local tumor progression after percutaneous radiofrequency ablation for lung neoplasms. Diagn Interv Radiol 13(4):199–203
pubmed: 18092293
Hiraki T, Sakurai J, Tsuda T et al (2006) Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Cancer. 107(12):2873–2880
doi: 10.1002/cncr.22333
Gillams AR, Lees WR (2008) Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 18(4):672–677
doi: 10.1007/s00330-007-0811-y
Laimer G, Schullian P, Jaschke N et al (2020) Minimal ablative margin (MAM) assessment with image fusion: an independent predictor for local tumor progression in hepatocellular carcinoma after stereotactic radiofrequency ablation. Eur Radiol 30(5):2463–2472
doi: 10.1007/s00330-019-06609-7
Wang X, Sofocleous CT, Erinjeri JP et al (2013) Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases. Cardiovasc Intervent Radiol 36(1):166–175
doi: 10.1007/s00270-012-0377-1
Hiraki T, Gobara H, Mimura H et al (2010) Does tumor type affect local control by radiofrequency ablation in the lungs? Eur J Radiol 74(1):136–141
doi: 10.1016/j.ejrad.2009.01.026
Zorbas G, Samaras T (2015) A study of the sink effect by blood vessels in radiofrequency ablation. Comput Biol Med 57:182–186
doi: 10.1016/j.compbiomed.2014.12.014
Kurilova I, Gonzalez-Aguirre A, Beets-Tan RG et al (2018) Microwave ablation in the management of colorectal cancer pulmonary metastases. Cardiovasc Intervent Radiol 41(10):1530–1544
doi: 10.1007/s00270-018-2000-6
Callstrom MR, Woodrum DA, Nichols FC et al (2020) Multicenter Study of Metastatic Lung Tumors Targeted by Interventional Cryoablation Evaluation (SOLSTICE). J Thorac Oncol 15(7):1200–1209
doi: 10.1016/j.jtho.2020.02.022