Radiofrequency ablation for pulmonary metastases from esophageal squamous cell carcinoma.

138 Background: Radiofrequency ablation (RFA) is increasingly being used for the treatment of intrathoracic malignancies. Although RFA has been found to be promising in the treatment of lung metastases from some types of neoplasms, little is known concerning its clinical significance in the treatment of pulmonary metastasis from esophageal squamous cell carcinoma (ESCC). This retrospective study evaluated the feasibility, safety, and effectiveness of computed tomography-guided RFA for pulmonary metastasis from ESCC. Methods: Of 322 patients with ESCC underwent esophagectomy at Kumamoto University Hospital between January 2007 and May 2015, 23 cases had pulmonary recurrence. Selection criteria for CT-guided RFA for pulmonary metastasis were as follows: (i) there were no distant metastases except for pulmonary lesions, when there were extrapulmonary recurrences that had to be controlled by additional therapies; (ii) there were up to three pulmonary tumors; (iii) the number of pulmonary tumors did not increase over a certain period while receiving pre-RFA chemotherapy; (iv) the metastatic lesions were not adjacent to major pulmonary vessels, major bronchi, or the heart. 17 patients who underwent CT-guided RFA for metachronous pulmonary metastasis from ESCC were included in this study. Results: Correct placement of the ablation device into the target tumor proved to be feasible in all tumors (100%). The mean visual analog scale score, with values that ranged from 0 (no pain) to 10 (worst pain possible), was 1. This suggested that this procedure was well tolerated. No procedure-related deaths occurred. A pneumothorax needing drainage was a major complication in two patients. 6 patients died of recurrent disease. The predicted 1- and 2-year overall survival rates after lung RFA were 78.8% and 46.7%, respectively. Conclusions: Percutaneous computed tomography-guided RFA yielded relatively high levels of local control in patients with pulmonary metastases from ESCC and was associated with an acceptable level of complications. It was concluded that a prospective study will be necessary to evaluate the effectiveness of a combination of systemic therapy and RFA for ESCC lung metastases.