Clinical Study
Radiofrequency Ablation for Ground-Glass Opacity–Dominant Lung Adenocarcinoma

https://doi.org/10.1016/j.jvir.2013.11.035Get rights and content

Abstract

Purpose

To evaluate retrospectively the clinical utility of lung radiofrequency (RF) ablation for the treatment of ground-glass opacity (GGO)–dominant lung adenocarcinoma.

Materials and Methods

From August 2004 through May 2012, 33 consecutive patients (14 men and 19 women; mean age, 71.1 y; age range, 46–84 y) with 42 lung tumors having ≥ 50% GGO component received lung RF ablation. The mean maximum tumor diameter was 1.6 cm ± 0.9 (range, 0.7–4.0 cm). Feasibility, safety, local tumor progression, and survival were evaluated.

Results

For the 42 RF sessions, after RF electrodes were placed in each target tumor, planned ablation protocols were completed in all sessions (100%; 42 of 42). No deaths related to the RF procedure occurred. Major and minor complication rates were 4.8% and 23.8%, respectively. Local tumor progression developed in 6 tumors (14.3%; 6 of 42) during a mean follow-up of 42 months ± 23 (range, 5–92 mo). Four of six tumors with local progression were controlled by repeated RF ablation. No evidence of disease was achieved in 31 of 33 patients (93.9%) at the end of the follow-up period. All but one patient (who died of brain hemorrhage) are alive today. Overall and cancer-specific survival rates were 100% and 100% at 1 year, 96.4% (95% confidence interval [CI], 77.5%–99.5%) and 100% at 3 years, and 96.4% (95% CI, 77.5%–99.5%) and 100% at 5 years, respectively.

Conclusions

Lung RF ablation is a feasible, safe, and useful therapeutic option to control GGO-dominant lung adenocarcinoma.

Section snippets

Study Design

This retrospective study was approved by our institutional review board. The necessity of informed consent for inclusion in this study was waived. Informed consent to perform lung RF ablation was obtained from all patients.

Patients

During August 2004 through May 2012, 33 consecutive patients with GGO-dominant primary lung cancer received curative lung RF ablation. Lung RF ablation was performed because of poor pulmonary function and difficulty in performing repeat surgery in 18 postoperative patients,

Feasibility and Safety

For 42 tumors, 42 RF sessions were performed (1.0 RF sessions/tumor). RF electrodes were placed into planned sites, and ablation was completed with planned protocol in all tumors. The technical success rate was 100% (42 of 42). In some instances, it was difficult to evaluate whether ablative zones completely covered tumors because both tumors and ablative zones had GGO character (15). In such cases, technical effectiveness was evaluated by referencing the anatomic landmark such as vessels.

Discussion

Results suggest that lung RF ablation is a safe and useful therapeutic option for the treatment of GGO-dominant primary lung cancer. A GGO lesion is a hazy opacity and less visible on CT fluoroscopic images compared with solid tumor. However, it was feasible to place the RF electrode at the planned site similar to CT fluoroscopic guided lung biopsy for GGO lesions (16). GGO-dominant tumors contain more air, so there might be a concern about anticancer effects of RF ablation because of less

References (29)

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None of the authors have identified a conflict of interest.

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