Peter John Littrup MD, Abstract Co-Author: Consultant, Endocare, Inc Research support, Endocare, Inc

Hussein D. Aoun MD, Presenter: Nothing to Disclose

Deepa Ann Cyriac MD, Abstract Co-Author: Nothing to Disclose

Barb Adam BA, Abstract Co-Author: Nothing to Disclose

Radiofrequency (RF) ablation has recurrence rates over 40% near vasculature and is limited near bronchi. We assessed complications and outcomes of our percutaneous thoracic cryotherapy series, up to and beyond 12 months.

Ninety-four CT fluoroscopic-guided, percutaneous cryoablations were performed on 117 tumors (29 primary lung cancer, 88 metastases) in 58 patients, noting tumor size and abutting vessels>3mm. Tandem urethral warming balloons (N= 5) and/or normal saline injection (N=1) were used to protect the esophagus. Patients received CT or MRI at ~1, 3, 6, 12, 18, 24 months and yearly thereafter. All complications were graded according to Common Toxicity Criteria for Adverse Events Version 3.0 (CTCAE) of the National Cancer Institute.

All patients required only conscious sedation. The ablated tumors and ice balls had mean diameters of 3.0 cm and 4.7 cm, respectively. Major grade >3 and self-limited minor complications occurred following 9 (10%) and 44 (48%) procedures, respectively. After an average follow-up of 11 months, the total local recurrence of 20% (21/107) was not different for masses >3cm (22% = 8/27) vs. <3cm (18% = 14/80) (p>0.1). A trend for greater local recurrence rate of 24% (15/54) for peri-vascular vs. non-vascular masses 11% (6/53) was noted (p<0.1).

Percutaneous CT-guided pulmonary cryotherapy requires more closely spaced probes for larger and perivascular masses to achieve low recurrence rates well below reported RF rates. Careful cardiac and pulmonary evaluation is also needed in high risk patients with severe co-morbidities.

Presentation Preference: Paper Only Category: Lung Ablation  

Littrup, P, Aoun, H, Cyriac, D, Adam, B, Recurrence Following Percutaneous Cryotherapy of Lung Tumors: Relation to Tumor Size and Vessel Proximity.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/7122569.html