Nahum Calvo, Presenter: Nothing to Disclose

Belen Intriago MD, Abstract Co-Author: Nothing to Disclose

Juan Escobar MD, Abstract Co-Author: Nothing to Disclose

Elena Rebenaque MD, MD, Abstract Co-Author: Nothing to Disclose

Manuel Montero, Abstract Co-Author: Nothing to Disclose

Lidón Millá MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to establish if there was any benefit in treating a malignant pulmonary nodule with more than one ablation in the same treatment session and to establish the rate of complications and local progression after RFA.

A prospective study was performed including patients with malignant nodules (< 3cm) treated with RFA, with confirmation of malignancy (either primary or metastatic) and where conventional surgery was not indicated. Group A includes nodules treated with one ablation and group B nodules treated with two or more ablations, using an 14G multitined expandable electrode (Le Veen; Boston Scientifics), 4 cm array. Local progression was assessed with modified RECIST criteria and F18-FDG-PET/CT-scan in the last 18 patients recruited. Statistical analysis: Chi square test and OR.  

35 nodules were treated with RFA (primary tumors n =15 and metastasis n=20). Group A includes 10 nodules/7 patients (median size:13,6;range 8-30 mm). Group B: 25 nodules/19 patients (18,6 ;range 4-30 mm). Nodule’s size was smaller in group A (p<0.05). Post-treatment complications (follow-up:13; range 6-39 months) appeared in 5 patients: 3 pneumothorax requiring drainage (2 patients in group A and 1 in B) and 2 infections (group B). Local tumor progression valued by RECIST criteria resulted in 2 progressions in group A and 1 in B. Complete response in 32/35 lesions. PET/CT showed absence of uptake in 18/18 patients. No statistical correlation was found between the different variables: age, numbers of ablations, post-treatment complications. Local tumor progression rate resulted significant lower in group B (p<0,10).

This study shows that multiablation of a single nodule at the same session is practicable in all age groups, for any lesion (< 3 cm). It doesn’t correlate with more post-treatment complications and, despite the small sample size, the outcome results in a lower rate of local recurrence compared to the single lesion ablation.

This procedure seems to be more efficient in reducing the rate of local recurrence without increasing the rate of treatment complications and seems effective at all ages and for all nodules < 3 cm.

Calvo, N, Intriago, B, Escobar, J, Rebenaque, E, Montero, M, Millá, L, Treating Small Lung Nodules with More than a Single Radiofrequency Ablation (RFA): Impact in Local Efficacy.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005628.html