Radiofrequency ablation of pulmonary tumors near the diaphragm

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Abstract

Purpose To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. Materials and methods A total of 26 patients (15 men, 11 women; mean age, 61.5 years ± 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance < 10 mm) were included. Mean tumor diameter was 11.0 mm ± 5.3 (SD) (range, 2–23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade ≥ 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance ≥ 10 mm). Results RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade ≥ 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P = 0.839). Shoulder pain (P < 0.001) and grade 1 pleural effusion (P < 0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade ≥ 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083). Conclusion RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.

Original languageEnglish
Pages (from-to)535-541
Number of pages7
JournalDiagnostic and interventional imaging
Volume98
Issue number7-8
DOIs
Publication statusPublished - Jul 1 2017

Fingerprint

Diaphragm
Lung
Neoplasms
Shoulder Pain
Pleural Effusion
Pleurodesis
Phrenic Nerve
National Cancer Institute (U.S.)
Pneumothorax
Terminology

Keywords

  • Diaphragm
  • Interventional imaging
  • Lung
  • Lung cancer
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

Cite this

@article{62b55ba028b6459a9d4a5469f481f896,
title = "Radiofrequency ablation of pulmonary tumors near the diaphragm",
abstract = "Purpose To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. Materials and methods A total of 26 patients (15 men, 11 women; mean age, 61.5 years ± 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance < 10 mm) were included. Mean tumor diameter was 11.0 mm ± 5.3 (SD) (range, 2–23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade ≥ 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance ≥ 10 mm). Results RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade ≥ 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2{\%} at 1 year and 96.2{\%} at 2 years and were not different, from those observed in control subjects (186 tumors; P = 0.839). Shoulder pain (P < 0.001) and grade 1 pleural effusion (P < 0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade ≥ 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083). Conclusion RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.",
keywords = "Diaphragm, Interventional imaging, Lung, Lung cancer, Radiofrequency ablation",
author = "T. Iguchi and T. Hiraki and H. Gobara and H. Fujiwara and J. Sakurai and Y. Matsui and T. Mitsuhashi and S. Toyooka and S. Kanazawa",
year = "2017",
month = "7",
day = "1",
doi = "10.1016/j.diii.2017.01.008",
language = "English",
volume = "98",
pages = "535--541",
journal = "Diagnostic and interventional imaging",
issn = "2211-5684",
publisher = "Elsevier Masson",
number = "7-8",

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TY - JOUR

T1 - Radiofrequency ablation of pulmonary tumors near the diaphragm

AU - Iguchi, T.

AU - Hiraki, T.

AU - Gobara, H.

AU - Fujiwara, H.

AU - Sakurai, J.

AU - Matsui, Y.

AU - Mitsuhashi, T.

AU - Toyooka, S.

AU - Kanazawa, S.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Purpose To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. Materials and methods A total of 26 patients (15 men, 11 women; mean age, 61.5 years ± 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance < 10 mm) were included. Mean tumor diameter was 11.0 mm ± 5.3 (SD) (range, 2–23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade ≥ 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance ≥ 10 mm). Results RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade ≥ 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P = 0.839). Shoulder pain (P < 0.001) and grade 1 pleural effusion (P < 0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade ≥ 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083). Conclusion RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.

AB - Purpose To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. Materials and methods A total of 26 patients (15 men, 11 women; mean age, 61.5 years ± 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance < 10 mm) were included. Mean tumor diameter was 11.0 mm ± 5.3 (SD) (range, 2–23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade ≥ 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance ≥ 10 mm). Results RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade ≥ 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P = 0.839). Shoulder pain (P < 0.001) and grade 1 pleural effusion (P < 0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade ≥ 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083). Conclusion RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors.

KW - Diaphragm

KW - Interventional imaging

KW - Lung

KW - Lung cancer

KW - Radiofrequency ablation

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