Skip to main content
SpringerLink
Log in

Radiofrequenzablation (RFA) von Lungenmetastasen kolorektaler Karzinome (KRK)—Ergebnisse nach einem Jahr

Radiofrequency ablation (RFA) of lung metastases from colorectal cancer (CRC)—one-year follow-up

  • Perkutane Ablation von Lungenmetastasen
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Die CT-gesteuerte Radiofrequenzablation (RFA) primärer und sekundärer Lungentumoren ist im Begriff, sich als minimal-invasive therapeutische Option zur lokalen Kontrolle der Lungenherde zu etablieren.

Sie kommt bei einem Patientenkollektiv zur Anwendung, das entweder aufgrund der limitierten kardiopulmonalen Reserven oder sonstiger Komorbiditäten nicht für eine Vollnarkose und/oder Lungenresektion in Frage kommt, oder dessen Lungenherde in Zahl, Verteilung und Größe eine Operation nicht sinnvoll erscheinen lassen.

Die bisherigen Kurzzeitverläufe zeigen erfolgversprechende Ergebnisse.

Abstract

Assess the safety and evidence of efficacy of RFA for colorectal (CRC) lung metastases with follow up to1 year. Twenty-three patients had percutaneous RFA for 52 colorectal pulmonary metastases under fluoro-CT. Patients received IV conscious sedation and local analgesia with routine hospitalisation/monitoring for 24 h post RFA. Patients had CT scanning at 1 month and then 3 monthly with serum CEA assessment monthly and 3 monthly. All ablations were technically successful. Tumor diameter ranged from 0.3 to 4.2 cm. Pneumothorax occurred in 43% (10 of 23) of patients. Six patients required intercostal chest drain placement. Six patients had a second RFA, 4 for new lesions and 2 patients had a previously treated lesion retreated. Median admission was 2.0 days (range 1–9). Median follow-up is 428 days (range 173–829), with data reported to 1 year in this paper. Five patients died at 5, 6, 8, 8 and 12 months post RFA from extra-pulmonary (1) or widespread (4) disease. One patient developed malignant pleural effusion at 6 months after RFA. Cavitation was seen in nine treated lesions (17%), all resolved with scar tissue contraction by 12 months. Eighteen patients with CT scan follow-up at one year have 40 lesions classified as: disappeared (17), decreased (5), stable/same size (4), increased (14). Percutaneous imaging–guided RFA of multiple CRC pulmonary metastases is a minimally invasive treatment option with modest morbidity. A significant proportion of patients show good evidence of successful local control at one year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Faivre J, Bouvier AM, Bonithon-Kopp C (2002) Epidemiology and screening of colorectal cancer. Best Pract Res Clin Gastroenterol 16:187–199

    Article  PubMed  Google Scholar 

  2. Davidson RS, Nwogu CE, Brentjens MJ, Anderson TM (2001) The surgical management of pulmonary metastasis: current concepts. Surg Oncol 10:35–42

    Article  CAS  PubMed  Google Scholar 

  3. McCormack PM, Ginsberg RJ (1998) Current management of colorectal metastases to lung. Chest Surg Clin North Am 8:119–126

    CAS  Google Scholar 

  4. Okumura S, Kondo H, Tsuboi M, Nakayama H, Asamura H, Tsuchiya R, Naruke T (1996) Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 112:867–874

    CAS  PubMed  Google Scholar 

  5. Penna C, Nordlinger B (2002) Colorectal metastasis (liver and lung). Surg Clin North Am 82:1075–1090

    PubMed  Google Scholar 

  6. Finlay IG, Seifert JK, Stewart GJ, Morris DL (2000) Resection with cryotherapy of colorectal hepatic metastases has the same survival as hepatic resection alone. Eur J Surg Oncol 26:199–202

    Article  CAS  PubMed  Google Scholar 

  7. Ruers T, Bleichrodt RP (2002) Treatment of liver metastases, an update on the possibilities and results. Eur J Cancer 38:1023–1033

    Article  CAS  PubMed  Google Scholar 

  8. Solbiati L, Livraghi T, Goldberg SN, Ierace T, Meloni F, Dellanoce M, Cova L, Halpern EF, Gazelle GS (2001) Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 221:159–166

    CAS  PubMed  Google Scholar 

  9. Curley SA, Izzo F, Delrio P, Ellis LM, Granchi J, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies. Results in 123 patients. Ann Surg 230:1–8

    Article  CAS  PubMed  Google Scholar 

  10. Curley SA, Izzo F, Ellis L, Vauthey JN, Vallone P (2000) Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 232:381–391

    Article  CAS  PubMed  Google Scholar 

  11. Iannitti DA, Dupuy DE, Mayo-Smith WW, Murphy B (2002) Hepatic radiofrequency ablation. Arch Surg 137:422–426

    Article  PubMed  Google Scholar 

  12. Bowles BJ, Machi J, Limm WM, Severino R, Oishi AJ, Furumoto NL, Wong LL, Oishi RH (2001) Safety and efficacy of radiofrequency thermal ablation in advanced liver tumors. Arch Surg 136:864–869

    Article  CAS  PubMed  Google Scholar 

  13. Davidson RS, Nwogu CE, Brentjens MJ, Anderson TM (2001) The surgical management of pulmonary metastasis: current concepts. Surg Oncol 10:35–42

    Article  CAS  PubMed  Google Scholar 

  14. Landreneau RJ, Sugarbaker DJ, Mack MJ, Hazelrigg SR, Luketich JD, Fetterman L, Liptay MJ, Bartley S, Boley TM, Keenan RJ, Ferson PF, Weyant RJ, Naunheim KS (1997) Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg 113:691–698

    CAS  PubMed  Google Scholar 

  15. Ike H, Shimada H, Ohki S, Togo S, Yamaguchi S, Ichikawa Y (2002) Results of aggressive resection of lung metastases from colorectal carcinoma detected by intensive follow-up. Dis Colon Rectum 45:468–473

    PubMed  Google Scholar 

  16. Friedel G, Pastorino U, Buyse M, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam JB, Toomes H (1999) Resection of lung metastases: long-term results and prognostic analysis based on 5206 cases—The International Registry of Lung Metastases. Zentralbl Chir 124:96–103

    CAS  PubMed  Google Scholar 

  17. Jaklitsch MT, Mery CM, Lukanich JM, Richards WG, Bueno R, Swanson SJ, Mentzer SJ, Davis BD, Allred EN, Sugarbaker DJ (2001) Sequential thoracic metastasectomy prolongs survival by re-establishing local control within the chest. J Thorac Cardiovasc Surg 121:657–667

    Article  CAS  PubMed  Google Scholar 

  18. Mineo TC, Ambrogi V, Tonini G, Nofroni I (2001) Pulmonary metastasectomy: might the type of resection affect survival? J Surg Oncol 76:47–52

    Article  CAS  PubMed  Google Scholar 

  19. Dupuy DE, Mayo-Smith WW, Abbott GF, DiPetrillo T (2002) Clinical applications of radio-frequency tumor ablation in the thorax. Radiographics 22:259–269

    Google Scholar 

  20. Nishida T, Inoue K, Kawata Y, Izumi N, Nishiyama N, Kinoshita H, Matsuoka T, Toyoshima M (2002) Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 195:426–430

    Article  PubMed  Google Scholar 

  21. Steinke K, King J, Glenn D, Morris DL (2003) Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr 27:750–757

    Article  PubMed  Google Scholar 

  22. Steinke K, Glenn D, King J, Morris DL (2003) Percutaneous pulmonary radiofrequency ablation: difficulty achieving complete ablations in big lung lesions. Br J Radiol 76:742–745

    Article  CAS  PubMed  Google Scholar 

  23. Steinke K, Sewell PE, Dupuy D, Lencioni R, Helmberger T, Kee ST, Jacob AL, Glenn DW, King J, Morris DL (2004) Pulmonary radiofrequency ablation—an international study survey. Anticancer Res 24:339–343

    PubMed  Google Scholar 

  24. Richardson CM, Pointon KS, Manhire AR, Macfarlane JT (2002) Percutaneous lung biopsies: a survey of UK practice based on 5444 biopsies. Br J Radiol 75:731–735

    CAS  PubMed  Google Scholar 

  25. Saji H, Nakamura H, Tsuchida T, Tsuboi M, Kawate N, Konaka C, Kato H (2002) The incidence and the risk of pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy: the angle of the needle trajectory is a novel predictor. Chest 121:1521–1526

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Universitätsinstitut für Radiologie, Kantonsspital Basel

    K. Steinke

  2. Department of Surgery, UNSW, The St. George Hospital Sydney

    J. King & D. L. Morris

  3. Department of Radiology, UNSW, The St. George Hospital Sydney

    D. Glenn

  4. Universitätsinstitut für Radiologie, Kantonsspital, Petersgraben 4, 4051, Basel, Schweiz

    K. Steinke

Authors
  1. K. Steinke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. King
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Glenn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. L. Morris
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Steinke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steinke, K., King, J., Glenn, D. et al. Radiofrequenzablation (RFA) von Lungenmetastasen kolorektaler Karzinome (KRK)—Ergebnisse nach einem Jahr. Radiologe 44, 687–692 (2004). https://doi.org/10.1007/s00117-004-1071-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-004-1071-3

Schlüsselwörter

Keywords

Search

Navigation