Radiofrequency ablation of lung metastases arising from sarcoma.

Abstract

10041 Background: To evaluate radiofrequency ablation (RFA) in the treatment of lung metastases arising from sarcoma. Methods: Between 2002 and 2009, out of 100 patients treated for metastatic sarcoma, 47 presented lung metastases and no extra-pulmonary metastases were noted for 36. Twenty-nine patients (mean age 51 yrs) with a maximum of 5 lung metastases curable by RFA were followed prospectively. Lung RFA was performed under general anesthesia with CT guidance. The different endpoints were: complications, local efficacy (assessed by CT images during the follow-up period), survival (overall survival: OS; recurrence free survival : RFS). Results: Forty-seven metastases were treated by RFA. Mean size of metastases was 9mm (range 4-40mm). Median time between primary tumor and lung metastases was 26 months. Mean time between appearance of lung metastases and RFA was 5.5 months. For 2 patients, surgery was performed on one side and RFA on the other. For 27 patients, RFA treatment was carried out for all metastases. Median follow-up time was 50 months (28-72 months). Pneumothorax was the most frequent complication and occurred in 68.7% of the procedures. The 1 and 3-year OS rates were 92.2% and 65.2%, RFS was 7 months (3.5-10 months). Five recurrences on a RFA site were noted during follow-up, 4 were treated with chemotherapy due to evolution of the metastatic disease, one with surgery. Conclusions: RFA is safe and efficient in the treatment of lung metastases arising from sarcoma. In this series, the 3-year OS compares with the results obtained by surgical lung resection. As local treatment is thought to contribute to the survival of sarcoma patients with lung metastases, RFA may be a low morbidity alternative to surgery. No significant financial relationships to disclose.