Local progression after radiofrequency ablation for pulmonary metastases.

von Meyenfeldt, Erik M; Prevoo, Warner; Peyrot, David; Lai A Fat, Nathalie; Burgers, Sjaak J A; Wouters, Michel W; Klomp, Houke M

BACKGROUND Local treatment for pulmonary metastases is considered to be a reasonable treatment option in patients with oligometastatic disease. Percutaneous radio frequency ablation (RFA) has been reported as an alternative to surgery. Results of RFA for local control of pulmonary metastases were evaluated. METHODS All consecutive patients treated with RFA for pulmonary metastases (2004-2009) were included. RFA was performed percutaneously under computed tomographic guidance. Follow-up was scheduled at 1, 3, and 6 months after treatment and every 6 months thereafter. Major outcome parameters were local and any-site progression, complications, and survival. RESULTS Ninety pulmonary metastases were treated, in 46 patients at 65 sessions. Many patients had recurrent metastases after previous surgery (n = 36 of 46). Pneumothorax occurred in 34% (chest drain in 25%) and major complications in 6%. After median follow-up of 22 months (range, 2-65 months), 25 local progressions occurred after RFA; the 2-year local progression rate per lesion was 35%. Overall survival at 3 years was 69%. CONCLUSIONS Notwithstanding its relatively low morbidity, follow-up after RFA for pulmonary metastases shows a considerable rate of local progression. The role of local ablation techniques for long-term disease control in oligometastatic disease is discussed.