Percutaneous cryoablation of adrenal metastases: technical feasibility and safety.
Adrenal metastases
Cryoablation
metastasectomy
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
20
07
2020
accepted:
30
10
2020
revised:
20
10
2020
pubmed:
6
2
2021
medline:
22
6
2021
entrez:
5
2
2021
Statut:
ppublish
Résumé
To assess the technical feasibility and outcomes of adrenal metastases cryoablation. This is an IRB approved retrospective review of adrenal metastases cryoablation between April 2003 and October 2018. Forty percutaneous cryoablation procedures were performed on 40 adrenal metastases in 34 patients. Histology, tumor size, ablation zone size, major vessel proximity, local recurrences, complications, and anesthesia-managed hypertension monitoring was collected. Complications were graded according to the Common Terminology of Complications and Adverse Events (CTCAE). Mean tumor and ablation size was 3.2 cm and 5.2 cm, respectively. Local recurrence rate was 10.0% (N = 4/40) for a mean follow-up time of 1.8 years. Recurrences for tumors > 3 cm (21.0%, N = 4/19) was greater than for tumors ≤ 3 cm (0.0%, N = 0/21) (p = 0.027). Proximity of major vasculature (i.e., IVC & aorta) did not statistically effect recurrence rates (p = 0.52), however, those that recurred near vasculature were > 4 cm. Major complication (≥ grade 3) rate was 5.0% (N = 2/40), with one major complication attributable to the procedure. Immediate escalation of blood pressure during the passive stick phase (between freeze cycles) or post procedure thaw phase was greater in patients with residual adrenal tissue (N = 21/38) versus masses replacing the entire adrenal gland (N = 17/38), (p = 0.0020). Lower blood pressure elevation was noted in patients with residual adrenal tissue who were pre-treated with alpha blockade (p = 0.015). CT-guided percutaneous cryoablation is a safe, effective and low morbidity alternative for patients with adrenal metastases. Transient hypertension is related only to residual viable adrenal tissue but can be safely managed and prophylactically treated.
Identifiants
pubmed: 33543315
doi: 10.1007/s00261-020-02848-1
pii: 10.1007/s00261-020-02848-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2805-2813Références
Arnold, D.T., J.B. Reed, and K. Burt, Evaluation and management of the incidental adrenal mass. Proc (Bayl Univ Med Cent), 2003. 16(1): p. 7-12 https://doi.org/10.1080/08998280.2003.11927882 .
doi: 10.1080/08998280.2003.11927882
Brunt, L.M. and J.F. Moley, Adrenal incidentaloma. World J Surg, 2001. 25(7): p. 905-13 https://doi.org/10.1007/s00268-001-0029-0 .
doi: 10.1007/s00268-001-0029-0
pubmed: 11572032
Thippeswamy, R., et al., Stage IV lung cancer: Is cure possible? Indian J Med Paediatr Oncol, 2013. 34(2): p. 121-5 https://doi.org/10.4103/0971-5851.116207 .
doi: 10.4103/0971-5851.116207
pubmed: 24049303
pmcid: 3764732
Popper, H.H., Progression and metastasis of lung cancer. Cancer Metastasis Rev, 2016. 35(1): p. 75-91 https://doi.org/10.1007/s10555-016-9618-0 .
doi: 10.1007/s10555-016-9618-0
pubmed: 27018053
pmcid: 4821869
Gryn, A., et al., Patient selection for laparoscopic excision of adrenal metastases: A multicenter cohort study. Int J Surg, 2015. 24(Pt A): p. 75-80 https://doi.org/10.1016/j.ijsu.2015.10.038 .
doi: 10.1016/j.ijsu.2015.10.038
pubmed: 26542988
Strong, V.E., et al., Laparoscopic adrenalectomy for isolated adrenal metastasis. Ann Surg Oncol, 2007. 14(12): p. 3392-400 https://doi.org/10.1245/s10434-007-9520-7 .
doi: 10.1245/s10434-007-9520-7
pubmed: 17665267
Tamura, T., et al., Specific organ metastases and survival in metastatic non-small-cell lung cancer. Mol Clin Oncol, 2015. 3(1): p. 217-221 https://doi.org/10.3892/mco.2014.410 .
doi: 10.3892/mco.2014.410
pubmed: 25469298
Patel, J.K., et al., Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg, 1978. 135(6): p. 807–10 DOI: https://doi.org/10.1016/0002-9610(78)90171-x .
Ng, L. and J.M. Libertino, Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol, 2003. 169(1): p. 5-11 https://doi.org/10.1097/01.ju.0000030148.59051.35 .
doi: 10.1097/01.ju.0000030148.59051.35
pubmed: 12478091
Allolio, B. and M. Fassnacht, Clinical review: Adrenocortical carcinoma: clinical update. J Clin Endocrinol Metab, 2006. 91(6): p. 2027-37 https://doi.org/10.1210/jc.2005-2639 .
doi: 10.1210/jc.2005-2639
pubmed: 16551738
Elder, E.E., G. Elder, and C. Larsson, Pheochromocytoma and functional paraganglioma syndrome: no longer the 10% tumor. J Surg Oncol, 2005. 89(3): p. 193-201 https://doi.org/10.1002/jso.20177 .
doi: 10.1002/jso.20177
pubmed: 15719371
Kebebew, E., et al., Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms. Arch Surg, 2002. 137(8): p. 948–51; discussion 952–3 DOI: https://doi.org/10.1001/archsurg.137.8.948 .
Muth, A., et al., Prognostic factors for survival after surgery for adrenal metastasis. Eur J Surg Oncol, 2010. 36(7): p. 699-704 https://doi.org/10.1016/j.ejso.2010.04.002 .
doi: 10.1016/j.ejso.2010.04.002
pubmed: 20452170
Rudra, S., et al., Stereotactic body radiation therapy for curative treatment of adrenal metastases. Technol Cancer Res Treat, 2013. 12(3): p. 217-24 https://doi.org/10.7785/tcrt.2012.500320 .
doi: 10.7785/tcrt.2012.500320
pubmed: 23369155
Ahmed, K.A., et al., Stereotactic body radiotherapy in the treatment of adrenal metastases. Am J Clin Oncol, 2013. 36(5): p. 509-13 https://doi.org/10.1097/COC.0b013e3182569189 .
doi: 10.1097/COC.0b013e3182569189
pubmed: 22781389
Holy, R., et al., Stereotactic body radiation therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer. Strahlenther Onkol, 2011. 187(4): p. 245-51 https://doi.org/10.1007/s00066-011-2192-z .
doi: 10.1007/s00066-011-2192-z
pubmed: 21424513
Scorsetti, M., et al., Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases: a retrospective analysis of 34 patients. Acta Oncol, 2012. 51(5): p. 618-23 https://doi.org/10.3109/0284186X.2011.652738 .
doi: 10.3109/0284186X.2011.652738
pubmed: 22263925
Frenk, N.E., et al., Local Control and Survival after Image-Guided Percutaneous Ablation of Adrenal Metastases. J Vasc Interv Radiol, 2018. 29(2): p. 276-284 https://doi.org/10.1016/j.jvir.2017.07.026 .
doi: 10.1016/j.jvir.2017.07.026
pubmed: 28927661
Aoun, H.D., et al., Percutaneous Cryoablation of Renal Tumors: Is It Time for a New Paradigm Shift? J Vasc Interv Radiol, 2017. 28(10): p. 1363-1370 https://doi.org/10.1016/j.jvir.2017.07.013 .
doi: 10.1016/j.jvir.2017.07.013
pubmed: 28844831
Welch, B.T., et al., Percutaneous image-guided adrenal cryoablation: procedural considerations and technical success. Radiology, 2011. 258(1): p. 301-7 https://doi.org/10.1148/radiol.10100631 .
doi: 10.1148/radiol.10100631
pubmed: 20971772
Welch, B.T., et al., A single-institution experience in image-guided thermal ablation of adrenal gland metastases. J Vasc Interv Radiol, 2014. 25(4): p. 593-8 https://doi.org/10.1016/j.jvir.2013.12.013 .
doi: 10.1016/j.jvir.2013.12.013
pubmed: 24507995
Littrup, P.J., et al., CT-guided percutaneous cryotherapy of renal masses. J Vasc Interv Radiol, 2007. 18(3): p. 383-92 https://doi.org/10.1016/j.jvir.2006.12.007 .
doi: 10.1016/j.jvir.2006.12.007
pubmed: 17377184
Littrup, P.J., et al., Lethal isotherms of cryoablation in a phantom study: effects of heat load, probe size, and number. J Vasc Interv Radiol, 2009. 20(10): p. 1343-51 https://doi.org/10.1016/j.jvir.2009.05.038 .
doi: 10.1016/j.jvir.2009.05.038
pubmed: 19695903
pmcid: 2762356
Weber, S.M., et al., Perivascular and intralesional tissue necrosis after hepatic cryoablation: results in a porcine model. Surgery, 1997. 122(4): p. 742-7 https://doi.org/10.1016/s0039-6060(97)90082-9 .
doi: 10.1016/s0039-6060(97)90082-9
pubmed: 9347851
Park, M.H., et al., Spectrum of CT findings after radiofrequency ablation of hepatic tumors. Radiographics, 2008. 28(2): p. 379–90; discussion 390–2 https://doi.org/10.1148/rg.282075038 .
Team, R.C., R: A language and environment for statistical computing. R Foundation for Statistical Computing, 2013.
Guiou, M., et al., Stereotactic body radiotherapy for adrenal metastases from lung cancer. Journal of Radiation Oncology, 2012. 1(2): p. 155-163 https://doi.org/10.1007/s13566-012-0037-8 .
doi: 10.1007/s13566-012-0037-8
Casamassima, F., et al., Stereotactic radiotherapy for adrenal gland metastases: university of Florence experience. Int J Radiat Oncol Biol Phys, 2012. 82(2): p. 919-23 https://doi.org/10.1016/j.ijrobp.2010.11.060 .
doi: 10.1016/j.ijrobp.2010.11.060
pubmed: 21300473
Wood, B.J., et al., Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer, 2003. 97(3): p. 554-60 https://doi.org/10.1002/cncr.11084 .
doi: 10.1002/cncr.11084
pubmed: 12548596
pmcid: 2443414
Wolf, F.J., et al., Adrenal neoplasms: Effectiveness and safety of CT-guided ablation of 23 tumors in 22 patients. Eur J Radiol, 2012. 81(8): p. 1717-23 https://doi.org/10.1016/j.ejrad.2011.04.054 .
doi: 10.1016/j.ejrad.2011.04.054
pubmed: 21636231
Hasegawa, T., et al., Unresectable Adrenal Metastases: Clinical Outcomes of Radiofrequency Ablation. Radiology, 2015. 277(2): p. 584-93 https://doi.org/10.1148/radiol.2015142029 .
doi: 10.1148/radiol.2015142029
pubmed: 25997031
Men, M., et al., Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study. Korean J Radiol, 2016. 17(6): p. 864-873 https://doi.org/10.3348/kjr.2016.17.6.864 .
doi: 10.3348/kjr.2016.17.6.864
pubmed: 27833402
pmcid: 5102914
Zerrweck, C., et al., Renal origin and size are independent predictors of survival after surgery for adrenal metastasis. Ann Surg Oncol, 2012. 19(11): p. 3621-6 https://doi.org/10.1245/s10434-012-2464-6 .
doi: 10.1245/s10434-012-2464-6
pubmed: 22752378
Fintelmann, F.J., et al., Catecholamine Surge during Image-Guided Ablation of Adrenal Gland Metastases: Predictors, Consequences, and Recommendations for Management. J Vasc Interv Radiol, 2016. 27(3): p. 395-402 https://doi.org/10.1016/j.jvir.2015.11.034 .
doi: 10.1016/j.jvir.2015.11.034
pubmed: 26724964
Nguyen, M.C., et al., The Adrenal Gland as a Sanctuary Site of Metastases After Pembrolizumab Treatment: A Case Series. J Natl Compr Canc Netw, 2018. 16(11): p. 1279-1283 https://doi.org/10.6004/jnccn.2018.7059 .
doi: 10.6004/jnccn.2018.7059
pubmed: 30442730