Percutaneous radiofrequency ablation for unresectable pulmonary metastases from renal cell carcinoma

OBJECTIVE To evaluate the clinical utility of lung radiofrequency ablation (RFA) in patients with unresectable pulmonary metastasis from renal cell carcinoma (RCC). PATIENTS AND METHODS We retrospectively examined 39 patients with unresectable metastases from RCC who were treated with lung RFA. Patients with six or fewer lung metastases measuring < 6 cm that were confined in the lung, had all lung tumours ablated (curative ablation). Patients with extrapulmonary lesions, seven or more lung tumours, or large tumours of > 6 cm, had mass reduction (palliative ablation). The primary endpoints was the overall survival, secondary endpoints were safety, local tumour progression rate, and recurrence-free survival in the curative ablation group. RESULTS There were significant differences in the overall survival rates between the curative and palliative groups at 1 year (100% vs 90%), 3 years (100% vs 52%) and 5 years (100% vs 52%) (P < 0.05). The maximum lung tumour diameter was also a significant prognostic factor. There was local tumour progression in 13 patients (33%) during the mean follow-up of 25 months. The recurrence-free survival rates were 92% at 1 year, 23% at 3 years and 23% at 5 years in the curative ablation group. Pneumothorax requiring chest tube placement (six of 89, 7%) and pneumonia (one of 89, 1%) were major complications. CONCLUSION Lung RFA is a safe and effective treatment for prolonging survival in patients with unresectable RCC lung metastases.