Percutaneous radiofrequency ablation of lung tumours: results in the mid-term

Radiofrequency ablation (RFA) of lung tumours has recently received much attention for the promising results achieved. Herein, we report the 5 years experience of a single referral centre in Europe, with particular reference to the mid-term results.

Between October 2001 and June 2005, we performed 88 RFAs of lung tumours, 9 of which were followed by surgical resection. The remaining 79 RFAs, the object of this paper, were performed to treat 64 lesions in 54 patients: 39 males and 15 females with a mean age of 71.7 years (range of 51-89). All patients had clinical or pathological evidence of the neoplastic lesion, which was non-small cell lung cancer (NSCLC) in 40 cases and a metastasis in 24 cases. The mean size of the lesions was 2.4 cm (range of 1-5). Ten lesions were re-treated from one to as many as four times. The procedure was always performed under local anaesthesia and conscious sedation. A generator of RF with max power output of 200W was utilised together with a needle with nine deployable electrodes, to achieve a target temperature of 90 degrees C that was maintained for 15-27 min according to the size of the lesions.

In all cases, except two, the procedure was technically successful. Morbidity consisted in 10 cases (12.7%) of partial pneumothorax, 1 haematoma of the chest wall and 1 pleural effusion. At a mean follow-up of 23.7 months (range of 6-50) we recorded a 61.9% of complete responses, with a higher rate in the metastatic lesions (70.8%) and in those smaller than 3 cm (69.7%). Mean (median) overall survival and local progression-free interval were 17.3 (28.9) months and 12.9 (24.1) months, respectively.

Efficacy of RFA in the mid-term seems to settle at a promising level, with better results for metastatic lesions and, above all, for lesions smaller than 3 cm. Notwithstanding these encouraging results, RFA remains an alternative local therapy only when surgery cannot be performed, especially in NSCLC.