Vol.:(0123456789) 1 3 Medical Oncology (2020) 37:35 https://doi.org/10.1007/s12032-020-01361-1 REVIEW ARTICLE RFA of primary and metastatic lung tumors: long‑term results Stefano Giusto Picchi 1  · Giulia Lassandro 1  · Andrea Bianco 2  · Andrea Coppola 3  · Anna Maria Ierardi 4  · Umberto G. Rossi 5  · Francesco Lassandro 6 Received: 17 January 2020 / Accepted: 10 March 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract The aim of our study is a retrospective evaluation of efectiveness and safety of Computed Tomography (CT)-guided radi- ofrequency ablation (RFA) therapy of primary and metastatic lung lesions in patients that cannot be considered surgical candidates. From February 2007 to September 2017, we performed 264 CT-guided ablation sessions on 264 lesions in 174 patients (112 M and 62 F; mean age, 68 years; range 36–83 years) afected by primary and metastatic lung lesions. The 45% of patients was afected by primary lung cancer, with size range lesion of 10–50 mm, and the 55% by metastatic lung lesions with size range of 5–49 mm. All patients had no more than three metastases in the lung and pulmonary relapses were treated up to three times. Overall Survival (OS), Progression-Free Survival (PFS), Local Progression-Free Survival (LPFS) and Cancer-specifc survival (CSS) at 1, 3 and 5 years were calculated both in primary lung tumors and in metastatic patients. Immediate and late RFA-related complications were reported. Pulmonary function tests were evaluated after the procedures. The efectiveness of RFA treatment was evaluated by contrast-enhanced CT. In patients afected by primary lung lesions, the OS rates were 66.73% at 1 year, 23.13% at 3 years and 16.19% at 5 years. In patients afected by metastatic lung lesions, the OS rates were 85.11%, 48.86% and 43.33%, respectively, at 1, 3 and 5 years. PFS at 1, 3 and 5 years were 79.8%, 60.42%, 15.4% in primary lung tumors and 78.59%, 51.8% and 6.07% in metastatic patients. LPFS at 1, 3 and 5 years were 79.8%, 64.69%, 18.87% in primary lung tumors and 86.29%, 69.15% and 44.45% in metastatic patients. CSS at 1, 3 and 5 years was 95.56%, 71.84%, 56.72% in primary lung tumors and 94.07%, 71% and 71% in metastatic patients. Immediate RFA-related complications (pneumothorax, pleural efusion and subcutaneous emphysema) were observed, respectively, in 42, 53 and 13 of 264 procedures (15.9%, 20% and 5%). There also occurred one major complication (lung abscess, 0.36%). No signifcant worsening of pulmonary function was noted. Our retrospective evaluation showed long-term efectiveness, safety and imaging features of CT-guided RFA in patients afected by primary and metastatic lung cancer as an alternative therapy in non-surgical candidates. Keywords Primary lung tumor · Lung metastases · RFA · Radiofrequency · Ablation · Survival · Interventional radiology Abbreviations RFA Radiofrequency ablation NSCLC Non-small cell lung cancer RT Radio-therapy MWA Microwave ablation CT Computed tomography OS Overall survival PFS Progression-free survival LPFS Local progression-free survival CSS Cancer-specifc survival SD Standard deviation * Francesco Lassandro f.lassandro@tiscali.it 1 Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy 2 Department of Pulmonology, Luigi Vanvitelli University, Naples, Italy 3 Radiology Unit, Insubria University, Varese, Italy 4 UOC Radiology Fondazione IRCSS Ca’ Grande Ospedale Maggiore Policlinico, Milan, Italy 5 Department of Diagnostic Imaging - Interventional Radiology Unit - EO Galliera Hospital, Genoa, Italy 6 Department of Radiology, Monaldi Hospital, Naples, Italy