Abstract:
INTRODUCTION:In this study, we reviewed a clinical series composed by all malignant lung lesions submitted to computed tomography-guided percutaneous thermal radiofrequency ablation, in our hospital, a rather recent technique that has been gaining scientific recognition. MATERIAL AND METHODS:For data purposes, all radiofrequency ablation and corresponding clinical records were retrospectively analysed. A computed tomography scan was performed before and after each procedure to evaluate the tumour's features, and at a second step to assess results and complications. The frequency of local recurrence and disease progression were determined based on imaging follow-up. Kaplan-Meier analysis was used to estimate survival. Univariate analysis recognized clinical and pathological factors affecting survival. These were also tested by multivariate analysis. RESULTS:A total of 28 malignant lung lesions, 20 primary and 8 metastatic, from 28 patients (78.6% male; mean age 62 ± 17 years old), were submitted to computed tomography-guided radiofrequency ablation between January 2004 and July 2010. Total necrosis was achieved in 74.1% of the lesions. Immediate radiofrequency ablation-related complications were observed in half of the procedures. Among major complications, death occurred in one patient only. Median overall survival was 43.0 months for a mean 2-years follow-up.Median progression-free survival was 31.6 months. Lesion's size smaller than 35 mm, stage III disease by the TNM classification and previous treatment attempts were significantly associated with better outcomes. Disease-related mortality was 46.4%. DISCUSSION:This procedure proved to be efficient to treat lung cancerous lesions, with a low-rate of major complications. CONCLUSIONS:Computed tomography-guided percutaneous radiofrequency ablation is a minimally invasive procedure that appears to be valuable in the treatment of lung cancer lesions. :Introdução: Neste estudo foram caracterizados e avaliados todos os tumores malignos do pulmão no nosso hospital submetidos a termoablação percutânea por radiofrequência guiada por tomografia computadorizada, uma técnica relativamente recente com crescente evidência científica. Material e Métodos: Os registos clínicos referentes a todas as termoablações percutâneas por radiofrequência realizadas na nossa instituição foram retrospectivamente analisados. Realizou-se uma tomografia computadorizada antes e depois de cada procedimento para avaliar as características do tumor e, numa segunda fase, para avaliar os resultados e complicações. A recorrência e progressão da doença foram determinados através do seguimento imagiológico. A análise Kaplan-Meier foi usada para calcular a sobrevivência. A análise univariada identificou os fatores clínicos e patológicos que afetaram a sobrevivência. Resultados: Um total de 28 lesões pulmonares malignas, 20 carcinomas primários e oito lesões metastáticas, de 28 doentes (78,6% do género masculino, com idade média de 62 ± 17 anos), foram submetidos a termoablação percutânea por radiofrequência entre janeiro de 2004 e julho de 2010. Obteve-se necrose total em 74,1% das lesões. Observaram-se complicações imediatas em metade dos procedimentos. Das principais complicações, ocorreu a morte em apenas um doente. A sobrevivência mediana global foi de 43,0 meses para uma média de dois anos de acompanhamento. A sobrevivência mediana sem progressão da doença foi de 31,6 meses. Os fatores que mostraram correlação estatisticamente significativa com melhores resultados foram: tamanho da lesão menor que 35 mm, doença no estádio III da classificação TNM e realização de tratamentos prévios. A mortalidade por progressão da doença foi de 46,4%. Discussão: Este procedimento provou ser eficaz no tratamento de lesões pulmonares cancerígenas, com uma baixa incidência de complicações graves. Conclusões: A termoablação percutânea por radiofrequência é um procedimento minimamente invasivo, que aparenta ser vantajoso no tratamento de lesões cancerígenas do pulmão.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Tavares E Castro A,Freitas S,Portilha A,Alves F,Caseiro-Alves Fdoi
10.20344/amp.5620subject
Has Abstractpub_date
2015-01-01 00:00:00pages
63-9issue
1eissn
0870-399Xissn
1646-0758journal_volume
28pub_type
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journal_title:Acta medica portuguesa
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