A novel strategy for treatment of metastatic pulmonary tumors: Radiofrequency ablation in conjunction with surgery

Introduction: Local treatment that includes surgical resection of metastatic pulmonary tumors is controversial because of the biologic features and invasiveness of these tumors. We report our experience with a premeditated treatment involving combined computed tomography-guided radiofrequency ablation and surgical resection in three patients with metastatic pulmonary tumors. Methods: Three patients underwent radiofrequency ablation in conjunction with surgical resection. The first was a 67-year-old man with pulmonary metastases of bronchial adenoid cystic carcinoma. We performed partial resection of five tumors in the right lung and ablated a tumor in the left lung. The second was a 66-year-old man with pulmonary metastases of renal cell carcinoma. He underwent radiofrequency ablation for three tumors in the right upper and middle lobes, and right lower lobectomy for tumors in that lobe. The third was a 55-year-old man with pulmonary metastases of high-grade sarcoma of the right thigh. We performed partial resection of five tumors in the left lung and ablated a tumor in the right lung. Results: Two patients had metastatic lesions on both sides of the lung; we performed surgical resection on one side and radiofrequency ablation contralaterally to avoid bilateral thoracotomy. The third patient underwent surgical resection and radiofrequency ablation to avoid highly invasive right pneumonectomy. All patients survived for more than 1 1/2 years after combination therapy. Conclusions: Premeditated treatment involving a combination of radiofrequency ablation and surgical resection can be a useful option in patients with metastatic pulmonary tumors, improving curability and avoiding highly invasive procedures.