PURPOSE: CT guided percutaneous Radio Frequency Ablation (RFA) of pulmonary lesions is an alternative option for patients being no candidates for surgery. The pulmonary function should not be impaired substantially by the procedure. In this study the pulmonary function subsequent to RFA of lung neoplasms as well as the morbidity related to the intervention was analyzed.
METHODS: A total of 30 CT guided percutaneous RFA procedures were performed (in a total of 21 patients) after discussion in the national comprehensive cancer centre due to limited pulmonary reserve or other co-morbidities. Histology was proofed by CT-guided percutaneous biopsy (NSCLC: n=25; pulmonary metastasis: n=5) prior to the RFA procedure (in general anesthesia, double lumen intubation). Morbidity related to the intervention and the pulmonary function subsequent to the intervention was analyzed.
RESULTS: The median forced expiratory volume (FEV1) pre RFA was 1.7l (range 0.7-2.9l; 65%, range 38%-129%). It was unchanged post RFA: 1.6l (range 1.1-2.4l; 64%, range 38%-118%) during median 168d follow-up (range 28- 393d). Pneumothorax requiring drainage as solely major complication occurred in 6/24 procedures (25%). Median hospitalization time was 5 days (range 4-12 days). Local control by CT was reached in all cases; systemic disease progress was verified by PET in 3 patients.
CONCLUSIONS: Mid-term change in pulmonary function due to pulmonary RFA has a negligible clinical impact. The rate of complications is tolerable.
CLINICAL IMPLICATIONS: RFA sems to be suitable especially in patients with severely limited pulmonary function, if other local strategies are unreasonable
DISCLOSURE: The following authors have nothing to disclose: Thomas Schneider, Michael Puderbach, Josef Kunz, Felix Herth, Hendrik Dienemann, Hans Hoffmann, Claus Heussel
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