Determinants of Local Progression After Computed Tomography-Guided Percutaneous Radiofrequency Ablation for Unresectable Lung Tumors: 9-Year Experience in a Single Institution |
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Authors: | Tomohisa Okuma Toshiyuki Matsuoka Akira Yamamoto Yoshimasa Oyama Shinichi Hamamoto Masami Toyoshima Kenji Nakamura Yukio Miki |
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Institution: | (1) Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan;(2) Department of Radiology, Kobe City Medical Center West Hospital, Kobe, Japan |
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Abstract: | The purpose of this study was to retrospectively determine the local control rate and contributing factors to local progression
after computed tomography (CT)-guided radiofrequency ablation (RFA) for unresectable lung tumor. This study included 138 lung
tumors in 72 patients (56 men and 16 women; age 70.0 ± 11.6 years (range 31–94); mean tumor size 2.1 ± 1.2 cm range 0.2–9])
who underwent lung RFA between June 2000 and May 2009. Mean follow-up periods for patients and tumors were 14 and 12 months,
respectively. The local progression-free rate and survival rate were calculated to determine the contributing factors to local
progression. During follow-up, 44 of 138 (32%) lung tumors showed local progression. The 1-, 2-, 3-, and 5-year overall local
control rates were 61, 57, 57, and 38%, respectively. The risk factors for local progression were age (≥70 years), tumor size
(≥2 cm), sex (male), and no achievement of roll-off during RFA (P < 0.05). Multivariate analysis identified tumor size ≥2 cm as the only independent factor for local progression (P = 0.003). For tumors <2 cm, 17 of 68 (25%) showed local progression, and the 1-, 2-, and 3-year overall local control rates
were 77, 73, and 73%, respectively. Multivariate analysis identified that age ≥70 years was an independent determinant of
local progression for tumors <2 cm in diameter (P = 0.011). The present study showed that 32% of lung tumors developed local progression after CT-guided RFA. The significant
risk factor for local progression after RFA for lung tumors was tumor size ≥2 cm. |
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