Radiofrequency Ablation Combined with Augmentation for Local Tumor Control of Skeletal Metastases

2021 ◽  
Author(s):  
A. Mermekli ◽  
N. Hare ◽  
R. Fairhead ◽  
D. K.C. Kuek ◽  
A. Gandhi ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Tumor Control ◽  
Skeletal Metastases ◽  
Tumor Control ◽  
Local Tumor

scholarly journals The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

2021 ◽  
Vol 28 (5) ◽  
pp. 4004-4015
Author(s):  
Claudio Pusceddu ◽  
Davide De Francesco ◽  
Luca Melis ◽  
Nicola Ballicu ◽  
Alessandro Fancellu
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Spinal Metastases ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Vertebral Augmentation ◽  
Local Tumor ◽  
Metastatic Lesions ◽  
The Mean

Aims: The purpose of this study was to assess the effectiveness of a navigational radiofrequency ablation device with concurrent vertebral augmentation in the treatment of posterior vertebral body metastatic lesions, which are technically difficult to access. Primary outcomes of the study were evaluation of pain palliation and radiologic assessment of local tumor control. Materials and Methods: Thirty-five patients with 41 vertebral spinal metastases involving the posterior vertebral body underwent computed tomography-guided percutaneous targeted radiofrequency ablation, with a navigational radiofrequency ablation device, associated with vertebral augmentation. Twenty-one patients (60%) had 1 or 2 metastatic lesions (Group A) and fourteen (40%) patients had multiple (>2) vertebral lesions (Group B). Changes in pain severity were evaluated by visual analog scale (VAS). Metastatic lesions were evaluated in terms of radiological local control. Results: The procedure was technically successful in all the treated vertebrae. Among the symptomatic patients, the mean VAS score dropped from 5.7 (95% CI 4.9–6.5) before tRFA and to 0.9 (95% CI 0.4–1.3) after tRFA (p < 0.001). The mean decrease in VAS score between baseline and one week follow up was 4.8 (95% CI 4.2–5.4). VAS decrease over time between one week and one year following radiofrequency ablation was similar, suggesting that pain relief was immediate and durable. Neither patients with 1–2 vertebral metastases, nor those with multiple lesions, showed radiological signs of local progression or recurrence of the tumor in the index vertebrae during a median follow up of 19 months (4–46 months) and 10 months (4–37 months), respectively. Conclusion: Treatment of spinal metastases with a navigational radiofrequency ablation device and vertebral augmentation can be used to obtain local tumor control with immediate and durable pain relief, providing effective treatment in the multimodality management of difficult-to-reach spinal metastases.

scholarly journals Laparoscopic Liver Resection versus Percutaneous Radiofrequency Ablation for Small Single Nodular Hepatocellular Carcinoma: Comparison of Treatment Outcomes

Liver Cancer ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 25-37
Author(s):  
Dong Ho Lee ◽  
Jing Woong Kim ◽  
Jeong Min Lee ◽  
Jong Man Kim ◽  
Min Woo Lee ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Treatment Outcomes ◽  
Cumulative Incidence ◽  
Laparoscopic Liver Resection ◽  
Local Tumor Control ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Percutaneous Radiofrequency Ablation ◽  
Local Tumor

<b><i>Background:</i></b> Treatment outcomes of laparoscopic liver resection (LLR) and percutaneous radiofrequency ablation (p-RFA) for small single hepatocellular carcinomas (HCCs) have not yet been fully compared. The aim of this study was to compare LLR and p-RFA as first-line treatment options in patients with single nodular HCCs ≤3 cm. <b><i>Methods:</i></b> From January 2014 to December 2016, a total of 566 patients with single nodular HCC ≤3 cm treated by either LLR (<i>n</i> = 251) or p-RFA (<i>n</i> = 315) were included. The recurrence-free survival (RFS) and cumulative incidence of local tumor progression (LTP) were estimated using Kaplan-Meier methods and compared using the log-rank test. Treatment outcome of 2 treatment modalities was compared in the subgroup of patients according to the tumor location. <b><i>Results:</i></b> There were no significant differences in overall survival between LLR and p-RFA (<i>p</i> = 0.160); however, 3-year RFS was demonstrated to be significantly higher after LLR (74.4%) than after p-RFA (66.0%) (<i>p</i> = 0.013), owing to its significantly lower cumulative incidence of LTP (2.1% at 3 years after LLR vs. 10.0% after p-RFA, <i>p</i> &#x3c; 0.001). The complication rate of p-RFA was significantly lower than that of LLR (5.1 vs. 10.0%, <i>p</i> = 0.026). LLR also provided significantly better local tumor control than p-RFA for subscapular tumors (3-year LTP rates: 1.9 vs. 8.8%, <i>p</i> = 0.012), perivascular tumors (3-year LTP rates: 0.0 vs. 17.2%, <i>p</i> = 0.007), and tumors located in anteroinfero-lateral liver portions (3-year LTP rates: 0.0 vs. 10.7%, <i>p</i> &#x3c; 0.001). However, there were no significant differences in LTP rates between LLR and p-RFA for non-subcapsular and non-perivascular tumors (<i>p</i> = 0.482) and for tumors in postero-superior liver portions (<i>p</i> = 0.380). <b><i>Conclusions:</i></b> LLR can provide significantly better local tumor control than p-RFA for small single HCCs in subcapsular, perivascular, and anteroinferolateral liver portions and thus may be the preferred treatment option for these tumors.

Repeat Radiofrequency Ablation for Local Progression of Lung Tumors: Does It Have a Role in Local Tumor Control?

2008 ◽  
Vol 19 (5) ◽  
pp. 706-711 ◽  
Author(s):  
Takao Hiraki ◽  
Hidefumi Mimura ◽  
Hideo Gobara ◽  
Yoshifumi Sano ◽  
Hiroyasu Fujiwara ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Lung Tumors ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Local Progression
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