Radiofrequency ablation as treatment for pulmonary metastasis of colorectal cancer

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30 Citations (Scopus)

Abstract

Radiofrequency ablation (RFA) causes focal coagulation necrosis in tissue. Its first clinical application was reported in 2000, and RFA has since been commonly used in both primary and metastatic lung cancer. The procedure is typically performed using computed tomography guidance, and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy. The most common complication is pneumothorax, which occurs in up to 50% of procedures; chest tube placement for pneumothorax is required in up to 25% of procedures. Other severe complications, such as pleural effusion requiring chest tube placement, infection, and nerve injury, are rare. The local efficacy depends on tumor size, and local progression after RFA is not rare, occurring in 10% or more of patients. The local progression rate is particularly high for tumors > 3 cm. Repeat RFA may be used to treat local progression. Short- to mid-term survival after RFA appears promising and is approximately 85%-95% at 1 year and 45%-55% at 3 years. Long-term survival data are sparse. Better survival may be expected for patients with small metastasis, low carcinoembryonic antigen levels, and/or no extrapulmonary metastasis. The notable advantages of RFA are that it is simple and minimally invasive; preserves pulmonary function; can be repeated; and is applicable regardless of previous treatments. Its most substantial limitation is limited local efficacy. Although surgery is still the method of choice for treatment with curative intent, the ultimate application of RFA may be to replace metastasectomy for small metastases. Randomized trials comparing RFA with surgery are needed.

Original languageEnglish
Pages (from-to)988-996
Number of pages9
JournalWorld Journal of Gastroenterology
Volume20
Issue number4
DOIs
Publication statusPublished - 2014

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Colorectal Neoplasms
Neoplasm Metastasis
Chest Tubes
Lung
Pneumothorax
Survival
Metastasectomy
Neoplasms
Carcinoembryonic Antigen
Pleural Effusion
Therapeutics
Lung Neoplasms
Electrodes
Necrosis
Tomography
Biopsy
Wounds and Injuries
Infection

Keywords

  • Ablation therapy
  • Colorectal cancer
  • Lung
  • Pulmonary metastases
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Radiofrequency ablation as treatment for pulmonary metastasis of colorectal cancer",
abstract = "Radiofrequency ablation (RFA) causes focal coagulation necrosis in tissue. Its first clinical application was reported in 2000, and RFA has since been commonly used in both primary and metastatic lung cancer. The procedure is typically performed using computed tomography guidance, and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy. The most common complication is pneumothorax, which occurs in up to 50{\%} of procedures; chest tube placement for pneumothorax is required in up to 25{\%} of procedures. Other severe complications, such as pleural effusion requiring chest tube placement, infection, and nerve injury, are rare. The local efficacy depends on tumor size, and local progression after RFA is not rare, occurring in 10{\%} or more of patients. The local progression rate is particularly high for tumors > 3 cm. Repeat RFA may be used to treat local progression. Short- to mid-term survival after RFA appears promising and is approximately 85{\%}-95{\%} at 1 year and 45{\%}-55{\%} at 3 years. Long-term survival data are sparse. Better survival may be expected for patients with small metastasis, low carcinoembryonic antigen levels, and/or no extrapulmonary metastasis. The notable advantages of RFA are that it is simple and minimally invasive; preserves pulmonary function; can be repeated; and is applicable regardless of previous treatments. Its most substantial limitation is limited local efficacy. Although surgery is still the method of choice for treatment with curative intent, the ultimate application of RFA may be to replace metastasectomy for small metastases. Randomized trials comparing RFA with surgery are needed.",
keywords = "Ablation therapy, Colorectal cancer, Lung, Pulmonary metastases, Radiofrequency ablation",
author = "Takao Hiraki and Hideo Gobara and Toshihiro Iguchi and Hiroyasu Fujiwara and Yusuke Matsui and Susumu Kanazawa",
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AU - Hiraki, Takao

AU - Gobara, Hideo

AU - Iguchi, Toshihiro

AU - Fujiwara, Hiroyasu

AU - Matsui, Yusuke

AU - Kanazawa, Susumu

PY - 2014

Y1 - 2014

N2 - Radiofrequency ablation (RFA) causes focal coagulation necrosis in tissue. Its first clinical application was reported in 2000, and RFA has since been commonly used in both primary and metastatic lung cancer. The procedure is typically performed using computed tomography guidance, and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy. The most common complication is pneumothorax, which occurs in up to 50% of procedures; chest tube placement for pneumothorax is required in up to 25% of procedures. Other severe complications, such as pleural effusion requiring chest tube placement, infection, and nerve injury, are rare. The local efficacy depends on tumor size, and local progression after RFA is not rare, occurring in 10% or more of patients. The local progression rate is particularly high for tumors > 3 cm. Repeat RFA may be used to treat local progression. Short- to mid-term survival after RFA appears promising and is approximately 85%-95% at 1 year and 45%-55% at 3 years. Long-term survival data are sparse. Better survival may be expected for patients with small metastasis, low carcinoembryonic antigen levels, and/or no extrapulmonary metastasis. The notable advantages of RFA are that it is simple and minimally invasive; preserves pulmonary function; can be repeated; and is applicable regardless of previous treatments. Its most substantial limitation is limited local efficacy. Although surgery is still the method of choice for treatment with curative intent, the ultimate application of RFA may be to replace metastasectomy for small metastases. Randomized trials comparing RFA with surgery are needed.

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