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Outcome after Radiofrequency Ablation of Sarcoma Lung Metastases

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Abstract

Purpose

Resection is the mainstay of management in patients with sarcoma lung metastases, but there is a limit to how many resections can be performed. Some patients with inoperable disease have small-volume lung metastases that are amenable to thermal ablation. We report our results after radiofrequency ablation (RFA).

Methods

This is a retrospective study of patients treated from 2007 to 2012 in whom the intention was to treat all sites of disease and who had a minimum CT follow-up of 4 months. Treatment was performed under general anesthesia/conscious sedation using cool-tip RFA. Follow-up CT scans were analyzed for local control. Primary tumor type, location, grade, disease-free interval, prior resection/chemotherapy, number and size of lung tumors, uni- or bilateral disease, complications, and overall and progression-free survival were recorded.

Results

Twenty-two patients [15 women; median age 48 (range 10–78) years] with 55 lung metastases were treated in 30 sessions. Mean and median tumor size and initial number were 0.9 cm and 0.7 (range 0.5–2) cm, and 2.5 and 1 (1–7) respectively. Median CT and clinical follow-up were 12 (4–54) and 20 (8–63) months, respectively. Primary local control rate was 52 of 55 (95 %). There were 2 of 30 (6.6 %) Common Terminology Criteria grade 3 complications with no long-term sequelae. Mean (median not reached) and 2- and 3-year overall survival were 51 months, and 94 and 85 %. Median and 1- and 2-year progression-free survival were 12 months, and 53 and 23 %. Prior disease-free interval was the only significant factor to affect overall survival.

Conclusion

RFA is a safe and effective treatment for patients with small-volume sarcoma metastases.

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References

  1. Tascilar M, Loos WJ, Seynaeve C et al (2007) The pharmacologic basis of ifosfamide use in adult patients with advanced soft tissue sarcomas. Oncologist 12:1351–1360

    Article  CAS  PubMed  Google Scholar 

  2. Rehders A, Hosch SB, Scheunemann P et al (2007) Benefit of surgical treatment of lung metastasis in soft tissue sarcoma. Arch Surg 142:70–75

    Article  PubMed  Google Scholar 

  3. Casiraghi M, De Pas T, Maisonneuve P et al (2011) A 10-year single-center experience on 708 lung metastasectomies: the evidence of the International Registry of Lung Metastases. J Thorac Oncol 6:1373–1378

    Article  PubMed  Google Scholar 

  4. Predina JD, Puc MM, Bergey MR et al (2011) Improved survival after pulmonary metastasectomy for soft tissue sarcoma. J Thorac Oncol 6:913–919

    Article  PubMed  Google Scholar 

  5. Hornbech K, Ravn J, Steinbruchel DA (2011) Outcome after pulmonary metastasectomy: analysis of 5 years consecutive surgical resections, 2002–2006. J Thorac Oncol 6:1733–1740

    Article  PubMed  Google Scholar 

  6. Pfannschmidt J, Klode J, Muley T et al (2006) Pulmonary metastasectomy in patients with soft tissue sarcomas: experiences in 50 patients. Thorac Cardiovasc Surg 54:489–492

    Article  CAS  PubMed  Google Scholar 

  7. Gillams AR, Lees WR (2008) Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 18:672–677

    Article  PubMed  Google Scholar 

  8. Nakamura T, Matsumine A, Yamakado K et al (2009) Lung radiofrequency ablation in patients with pulmonary metastases from musculoskeletal sarcomas [corrected]. Cancer 115:3774–3781

    Article  PubMed  Google Scholar 

  9. Palussiere J, Italiano A, Descat E et al (2011) Sarcoma lung metastases treated with percutaneous radiofrequency ablation: results from 29 patients. Ann Surg Oncol 18:3771–3777

    Article  CAS  PubMed  Google Scholar 

  10. Anderson EM, Lees WR, Gillams AR (2009) Early indicators of treatment success after percutaneous radiofrequency of pulmonary tumors. Cardiovasc Intervent Radiol 32:478–483

    Article  PubMed  Google Scholar 

  11. Bielack SS, Kempf-Bielack B, Branscheid D et al (2009) Second and subsequent recurrences of osteosarcoma: presentation, treatment, and outcomes of 249 consecutive cooperative osteosarcoma study group patients. J Clin Oncol 27:557–565

    Article  PubMed  Google Scholar 

  12. Liebl LS, Elson F, Quaas A et al (2007) Value of repeat resection for survival in pulmonary metastases from soft tissue sarcoma. Anticancer Res 27:2897–2902

    CAS  PubMed  Google Scholar 

  13. Lencioni R, Crocetti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 9:621–628

    Article  PubMed  Google Scholar 

  14. Tada A, Hiraki T, Iguchi T et al (2012) Influence of radiofrequency ablation of lung cancer on pulmonary function. Cardiovasc Intervent Radiol 35:860–867

    Article  PubMed  Google Scholar 

  15. Kim S, Ott HC, Wright CD et al (2011) Pulmonary resection of metastatic sarcoma: prognostic factors associated with improved outcomes. Ann Thorac Surg 92:1780–1786

    Article  PubMed  Google Scholar 

  16. Smith R, Pak Y, Kraybill W et al (2009) Factors associated with actual long-term survival following soft tissue sarcoma pulmonary metastasectomy. Eur J Surg Oncol 35:356–361

    Article  CAS  PubMed  Google Scholar 

  17. Ellis MC, Hessman CJ, Weerasinghe R et al (2011) Comparison of pulmonary nodule detection rates between preoperative CT imaging and intraoperative lung palpation. Am J Surg 201:619–622

    Article  PubMed  Google Scholar 

  18. Dhakal S, Corbin KS, Milano MT et al (2012) Stereotactic body radiotherapy for pulmonary metastases from soft-tissue sarcomas: excellent local lesion control and improved patient survival. Int J Radiat Oncol Biol Phys 82:940–945

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Alice Gillams.

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Koelblinger, C., Strauss, S. & Gillams, A. Outcome after Radiofrequency Ablation of Sarcoma Lung Metastases. Cardiovasc Intervent Radiol 37, 147–153 (2014). https://doi.org/10.1007/s00270-013-0644-9

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  • DOI: https://doi.org/10.1007/s00270-013-0644-9

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