Radiofrequency ablation (RFA) of pulmonary colorectal metastases

Abstract

3732 Background: Surgical resection is known to improve survival in patients with pulmonary colorectal metastases (CRPM) to the lung, but the majority of patients are not surgical candidates. Methods: Local control of pulmonary CRM was evaluated as part of two ongoing studies of percutaneous radiofrequency ablation (RFA) of both primary lung tumors or metastatic tumors to the lung in 96 enrolled patients. Fifty patients had 66 RFA procedures for 109 CRPM tumors. Image-guided RFA was performed and follow-up included computed tomography (CT) imaging at 1, 3, 6 and 12 months. Results: There were 2.2±1.6 CRCPM tumors (mean±SD) per patient with mean longest diameter of 1.4±0.7 cm. Patients had undergone prior chemotherapy (62%), or radiation therapy (4%) for their lung tumors. Mean lesion longest diameter decreased from 3.1±1.2 cm following RFA to 2.1±1.1, 1.6±1.0, and 1.4±1.3 at 3, 6 and 12 months, respectively. At 3, 6 and 12 months 30%; 44% and 62% of treated tumors showed a positive response (RECIST: CR; PR; SD). There were 33 pneumothoraces following 66 procedures (50%) with chest drain insertion required after 12 (18%) treatments with 3 (4.5%) of those required for pleural effusion. Procedure-related complications included self-limiting hemorrhage (3) and atelectasis/pneumonia (2). Patient median follow-up is 11.6 months (range 0 to 37.6 months). Conclusion: RFA provides effective local tumor control with low morbidity and may prove an important adjuvant therapy in patients with colorectal pulmonary metastases who are not surgical candidates. No significant financial relationships to disclose.