Repeat thermal ablation for local progression of lung tumours: how safe and efficacious is it?

Abstract

Aim: To retrospectively evaluate the safety and efficacy of repeat thermal ablation for local progression of lung tumours after prior ablation(s).

Methods: From December 2009 to March 2017, 13 patients underwent repeat ablation (11 repeat microwave ablations and 2 repeat radiofrequency ablations) of a lung tumour (9 non-small cell lung carcinomas, 3 metastatic colorectal adenocarcinomas, 1 metastatic pelvic sarcoma) for local progression after prior ablation(s). Safety of the procedure was assessed by presence or absence of adverse events. Efficacy of the procedure was assessed by local tumour response to ablation and survival time.

Results: Repeat ablation procedures were safe, without major adverse events. Median length of hospital stay was 2 days (interquartile range 1-2). Pneumothorax was the most common complication [5 (38%) of 13 repeat ablation procedures]. There was one death within 30 days of ablation, but the cause of death and its relation to the procedure were unknown. Of the 12 patients with imaging follow-up [median follow-up 26 months (range 3-62)], 10 (83%) had complete ablation and 2 (17%) had local progression. Of all 13 patients, 8 (62%) were alive and 5 (38%) had died with a median overall survival of 43 months (95% confidence interval 36-49 months).

Conclusion: Repeat ablation in locally progressing tumours after prior ablation attempt(s) is a safe therapeutic option and often achieves local tumour control.

Keywords

Local progression / lung tumours / microwave ablation / radiofrequency ablation / repeat ablation

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