Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device D. Lagana `, 1 G. Carrafiello, 1 M. Mangini, 1 L. Boni, 2 G. Dionigi, 2 M. C. Fusi, 1 L. Cinquepalmi, 2 F. Rovera, 2 S. Cuffari, 3 C. Fugazzola 1 1 Department of Radiology, University of Insubria, Verese, Italy 2 Department of Surgery, University of Insubria, Verese, Italy 3 Department of Anaesthesia, University of Insubria, Verese, Italy Received:1 September 2005/Accepted:15 February 2006/Online publication:20 July 2006 Abstract Background: This study aimed to assess the feasibility and short-term results for percutaneous radiofrequency ablation in the treatment of primary and secondary lung tumors. Methods: Between May 2003 and July 2004, 15 patients (mean age, 64.9 years; range, 51–80 years) with 18 pul- monary lesions (9 primitive non–small cell lung cancers and 9 metastases) underwent the ablation procedure. All the patients had absolute contraindications to the sur- gery.The procedure wasperformed under computed tomography (CT)guidance with anesthesiologic assis- tance using a coaxial Le Veen needle electrode. The re- sults were evaluated by postprocedural CT scan, and then by clinicaland laboratory examination and CT scan 1, 3, 6, 9, and 12 months after the treatment. Results: A complete ablation was obtained for 16 of 18 lesions (88.9%), and a partial ablation was achieved for the remaining 2 lesions (central tumors).In terms of complications, there were five cases of pneumothorax (2 resolved spontaneously and 3 were drained through a coaxialneedle), four middle pleural reactions, and one hemothorax that required draining surgically. Follow-up evaluation was performed for 16 of 18 lesions. Stability was observed in one of two central tumors that received partial ablation. The remaining 15 tumors that received a complete ablation were followed up for a mean of 5 months (range, 1–12 months). All 15 lesions appeared to be hypodense at the CT examination. Dimension reduc- tion with progressive fibrotic scar formation was observed in seven of seven lesions during a follow-up period of 6 months or more. A recurrence at the site of the treatment for two of three lesions was observed during a 12-month follow-up period. One of these received a second radio- frequency ablation. Five patients experienced systemic disease progression. In four of these five patients, this progression was not associated with recurrence at the sit of the treatment. Conclusion: Radiofrequency ablation seems to be possibl for ‘‘nonsurgical’’ patients with primary and secondary lung tumors. Good results in terms of local tumor control were observed during short-term follow-up evaluation. Key words: Lung tumor — Non–small cell lung cancer — Radiofrequency ablation Lung cancerstill is the mostfrequentcancer-related cause of death in both the United States and Europe, with almost 200,000 new cases diagnosed per year [3, 4] Furthermore, the lungs are one of the most common site of metastasis, involving 30% to 40% of all patients with various tumors [6]. Surgical resection still is considered the treatment of choice for non–small celllung cancer stages I,II, and IIIA, as wellas for carefully selected patientswith metastatic lesions[23].However,lung cancers often are diagnosed at advanced stages in pa- tients with chronic obstructive respiratory diseases, or in those with associated cardiovascular problems contra- indicating the surgical approach [15]. For such patients, palliative chemoradiotherapy is the only possible ther- apy. Radiofrequency(RF) thermalablation has been widely used with good results for primary and secondary hepatic neoplasms not suitable for surgical resection [7, 20].Limited experiences have also been reported with the use of RF thermal ablation for tumors of the kid- neys,bones,brain,breast,adrenalgland,parathyroid, and the prostrate gland [11]. Some experimental studies show thatRF applied to lung tumors is feasible and effective, causing only limited damage to the healthy surrounding tissue [1, 12]. Lung parenchyma seems to be ideal for RF thermal ablation becausethe aeratedparenchyma presents Correspondence to: L. Boni Surg Endosc (2006) 20:1262–1267 DOI:10.1007/s00464-005-0607-6 Ó Springer Science+Business Media, Inc. 2006