Michael David Beland MD, Presenter: Nothing to Disclose

Elliot Joseph Wasser MD, Abstract Co-Author: Nothing to Disclose

Albert Scappaticci, Abstract Co-Author: Nothing to Disclose

William W. Mayo-Smith MD, Abstract Co-Author: Research support, General Electric Company Research support, Bracco Group

Damian E. Dupuy MD, Abstract Co-Author: Consultant, Abla-Tx, Inc Consultant, Veran Medical Technologies, Inc Grant, Endocare, Inc Grant, Veran Medical Technologies, Inc Speakers Bureau, Covidien AG

To review the recurrence patterns of patients with primary lung cancer treated with percutaneous image guided radiofrequency ablation (RFA).

This retrospective review received institutional IRB approval and is HIPAA compliant. We reviewed our ablation database to identify all patients with primary lung cancer who have undergone lung RFA from January 1998 to January 2008. 94 patients were identified and their medical records and imaging studies were reviewed. Follow-up imaging was reviewed to assess for signs of recurrence. Correlation of imaging studies with results of operative results and pathology, when available, was performed. Patterns of recurrence were classified as local, intrapulmonary, nodal and distant.

Of the 94 patients treated, 10 had no post-treatment imaging and were considered lost to follow-up. Three patients had a second primary lung cancer ablated yielding a cohort of 87 primary lung cancers (84 NSCLC, 3 small cell) in 84 patients. Follow-up imaging demonstrated recurrence in 38 (44%) tumors. Histology of recurrent tumors was non-small cell lung (NSCLC) in 36 tumors and small cell in 2 tumors. Recurrence after RF ablation was local in 17 (45%) tumors, intrapulmonary in 6 (16%) tumors, nodal in 5 (13%) tumors and distant metastases in 7 (18%) tumors. Three (8%) tumors demonstrated a mixed pattern of local and nodal recurrence.

Recurrence of lung carcinoma is common (44%) after treatment with radiofrequency ablation. Patterns of recurrence included local (45%), intrapulmonary (16%), nodal (13%), distant (18%) and mixed (8%).  

The majority of primary lung cancer recurrences after RFA will be local or intrapulmonary. Knowledge of the patterns of recurrence is critical to interpreting follow-up imaging.

Beland, M, Wasser, E, Scappaticci, A, Mayo-Smith, W, Dupuy, D, Radiofrequency Ablation of Primary Lung Cancer: A Ten-Year Review of Patterns of Recurrence in 87 Tumors Treated from 1998 to 2008.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/7117057.html