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Lung radiofrequency ablation in patients with pulmonary metastases from musculoskeletal sarcomas
Authors:Tomoki Nakamura MD  PhD  Akihiko Matsumine MD  PhD  Koichiro Yamakado MD  PhD  Takao Matsubara MD  PhD  Haruyuki Takaki MD  PhD  Atsuhiro Nakatsuka MD  PhD  Kan Takeda MD  PhD  Daisuke Abo MD  PhD  Tadashi Shimizu MD  PhD  Atsumasa Uchida MD  PhD
Affiliation:1. Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2‐174, Edobashi, Tsu‐city, Mie, Japan;2. Fax: (011) 81‐59‐231‐5211;3. Department of Radiology, Mie University Graduate School of Medicine, Edobashi, Tsu‐city, Mie, Japan;4. Department of Radiology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
Abstract:

BACKGROUND:

The authors retrospectively evaluated the impact of lung radiofrequency (RF) ablation on survival in patients with lung metastases from musculoskeletal sarcomas.

METHODS:

Lung RF ablation was done under the real‐time computed tomography (CT) fluoroscopy. Safety, local tumor progression, and survival were evaluated in 2 institutions.

RESULTS:

Lung RF ablation was performed in 20 consecutive patients. The mean maximum tumor diameter was 14 ± 9 mm (range, 5‐40 mm) and the mean tumor number 7 ± 6 (range, 1‐18) per patient. Pneumothorax requiring chest tube placement developed in 24 of 63 RF sessions (38%). During the mean follow‐up period of 18 months (range, 7 months to 54 months), 9 of 20 patients died of lung tumor progression. The 1‐ and 3‐year survival rates from RF ablation were 58% (95% confidence interval [CI], 33.3‐82.6%) and 29% (95% CI, 0‐59.9%) with a median survival time of 12.9 months in all patients. Ablation of all lung tumors was the only significantly better prognostic factors in both the univariate analysis and the multivariate analyses. The 1‐ and 3‐year survival rates were 88.9% (95% CI, 69.3%‐100%) and 59.2% (95% CI, 10.2%‐100%) in 11 patients with complete tumor ablation.

CONCLUSIONS:

Lung RF ablation is a safe and useful therapeutic option for selected patients. (R#1) Prognostic factors identified in our study will help to stratify those patients who may benefit from lung RF ablation. Cancer 2009. © 2009 American Cancer Society.
Keywords:radiofrequency ablation  sarcoma  pulmonary metastasis  prognosis
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