Abstract

Purpose The purpose of this series was to evaluate the prognostic features for local progression in non‐surgical candidates after undergoing percutaneous RFA of lung tumours.Methodology From Nov 2000, a total of 233 lung neoplasms (9 primary) in 95 patients (56 males, mean age of 66 years) with a mininum follow‐up of 6 months were included in this study. The primary end point was local progression free interval defined from the time of RFA intervention. Local progression was defined as tumour recurrence of previously RFA treated site/s. Univariate and multivariate analysis were performed to identify significant prognostic parameters for post‐ablative tumour recurrence.Results The mean number of tumours ablated per patient was 2.5 while the mean diametre of tumours was 2.2 cm. After a median follow up period of 24 months (range: 6–54 months), 32% of ablated tumours recurred. The overall median local progression free interval was 20 months (range 3–54 months) with 1, 2 and 3 year local progression free survival of 82%, 74% and 68% respectively. Univariate analysis of lesion characteristics identified size (p = 0.0002), hilar location (p = 0.0141), proximity to bronchus (p = 0.009) and vessel (p = 0.001), number of ablations required per lesion (p = 0.0052) and post‐ablation and tumour volume ratio (p = 0.0002) as statistically significant prognostic factors for tumour recurrence. Multivariate analysis identified size of lung tumours >3 cm (p = 0.07) as an independent risk factor for local progression.Conclusion Percutaneous lung RFA may play a useful role as a local therapy in non‐surgical candidates with pulmonary neoplasms. However, the efficacy of local control may be restricted to lesions smaller than 3 cm.

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