Peter John Littrup MD, Presenter: Founder, CryoMedix, LLC Research Grant, Galil Medical Ltd Research Grant, Endo Health Solutions Inc Officer, Delphinus Medical Technologies, Inc

Hussein D. Aoun MD, Abstract Co-Author: Nothing to Disclose

Barbara A. Adam MSN, Abstract Co-Author: Nothing to Disclose

Brian Faustino Baigorri MD, Abstract Co-Author: Nothing to Disclose

Mohamed M. Jaber MD, Abstract Co-Author: Nothing to Disclose

Evan N. Fletcher MS, BA, Abstract Co-Author: Nothing to Disclose

Mark J. Krycia BS, Abstract Co-Author: Nothing to Disclose

Matthew Prus BS, Abstract Co-Author: Nothing to Disclose

To assess efficacy and complication outcomes for cryoablation of primary and metastatic thoracic tumors based on location. Tumor and ablation size, complications, and location were also assessed for single vs. multiple tumors per procedure.

CT fluoroscopic-guided percutaneous cryoablation was performed on 384 tumors in 283 procedures in 169 patients, noting tumor and ablation volumes, location, abutting vessels >3mm, recurrences, complications, and tumor type. In procedures with treatment of a single tumor, locations were designated as chest wall/pleural-based (n=113), pulmonary (n=53), and central (N=39). In addition, there were 179 tumors in procedures where multiple tumors were targeted in the same lung and outcomes noted separately. Complications were graded by the National Institutes of Health, Common Terminology of Complications and Adverse Events (CTCAE).

All patients required only conscious sedation. Overall tumor and ablation mean size was 2.6cm and 4.8cm, respectively. Total major complication rates were low at 5.3% (15/283). Tumor mean size was significantly larger in procedures with major complications (5.2cm) compared to those without (2.5cm, p<0.001). No significant difference in major complications was noted between locations for the 3 groups of single tumor ablation, as well as no difference between the combined single tumor ablation (5.9%, 12/205) compared to the multiple tumor ablation group (3.8%, 3/78; p>0.05). Total local tumor recurrence rates were low at 5.2% (20/384) and were not dependent upon tumor size or location, vessel proximity, or between single or multiple ablations per procedure.

CT guided thoracic cryoablation provides a low morbidity alternative for complex patients, particularly for central and chest wall/pleural-based tumors. Major complication rate was significantly higher for larger tumors, but there was no significant difference based on location or treatment of multiple tumors. Recurrence rates were not dependent upon any assessed factors.

Thoracic cryoablation has low recurrence and complication rates, even for multiple tumors in the same lung. Larger tumors may have lower complications if done in more than one session.

Littrup, P, Aoun, H, Adam, B, Baigorri, B, Jaber, M, Fletcher, E, Krycia, M, Prus, M, Thoracic Cryoablation Is Safe and Effective for Multiple Tumors per Procedure.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018232.html