Nathan E Frenk1, Dania Daye2, Kemal Tuncali3, Ronald S Arellano4, Paul B Shyn3, Stuart G Silverman3, Florian J Fintelmann5, Raul N Uppot4. 1. Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, 55 Fruit St, MA 02114. Electronic address: nathanfrenk@gmail.com. 2. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, 55 Fruit St, MA 02114. 3. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 4. Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, 55 Fruit St, MA 02114. 5. Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, 55 Fruit St, MA 02114.
Abstract
PURPOSE: To evaluate local control and survival after image-guided ablation of adrenal gland metastases. MATERIALS AND METHODS: Image-guided ablations of adrenal metastases measuring < 5 cm performed at 2 academic medical centers between July 2002 and June 2016 were analyzed. There were 51 procedures performed on 46 tumors (mean diameter 2.8 cm ± 1.1; range, 0.7-4.9 cm) in 38 patients (mean age 66 y; range, 41-80 y) with renal cell carcinoma (n = 17 patients; 45%), non-small cell lung cancer (n = 10 patients; 26%), and other primary malignancies (n = 11 patients; 29%). Treatment modalities included cryoablation (n = 30 procedures; 59%), radiofrequency ablation (n = 12 procedures; 24%) and microwave ablation (n = 9 procedures; 18%). Technical success, primary and secondary efficacy, local progression rate, local progression-free survival, and overall survival were assessed. Mean follow-up was 37 months (range, 2-128 months). Statistical analysis was performed with univariate Cox hazards regression and Kaplan-Meier analyses. RESULTS: Technical success, primary efficacy, and secondary efficacy were 96%, 72%, and 76%. Local progression rate during all follow-up was 25%. Local tumor progression-free survival at 1, 3, and 5 years was 82%, 69%, and 55%. Overall survival at 1, 3, and 5 years was 82%, 44%, and 34%. In 16 patients with isolated adrenal metastasis, median disease-free survival was 8 months; 4 patients had no evidence of disease during follow-up. Lung cancer was associated with decreased survival (hazard ratio 4.41, P = .002). CONCLUSIONS: Image-guided ablation can achieve local control for adrenal metastases < 5 cm.
PURPOSE: To evaluate local control and survival after image-guided ablation of adrenal gland metastases. MATERIALS AND METHODS: Image-guided ablations of adrenal metastases measuring < 5 cm performed at 2 academic medical centers between July 2002 and June 2016 were analyzed. There were 51 procedures performed on 46 tumors (mean diameter 2.8 cm ± 1.1; range, 0.7-4.9 cm) in 38 patients (mean age 66 y; range, 41-80 y) with renal cell carcinoma (n = 17 patients; 45%), non-small cell lung cancer (n = 10 patients; 26%), and other primary malignancies (n = 11 patients; 29%). Treatment modalities included cryoablation (n = 30 procedures; 59%), radiofrequency ablation (n = 12 procedures; 24%) and microwave ablation (n = 9 procedures; 18%). Technical success, primary and secondary efficacy, local progression rate, local progression-free survival, and overall survival were assessed. Mean follow-up was 37 months (range, 2-128 months). Statistical analysis was performed with univariate Cox hazards regression and Kaplan-Meier analyses. RESULTS: Technical success, primary efficacy, and secondary efficacy were 96%, 72%, and 76%. Local progression rate during all follow-up was 25%. Local tumor progression-free survival at 1, 3, and 5 years was 82%, 69%, and 55%. Overall survival at 1, 3, and 5 years was 82%, 44%, and 34%. In 16 patients with isolated adrenal metastasis, median disease-free survival was 8 months; 4 patients had no evidence of disease during follow-up. Lung cancer was associated with decreased survival (hazard ratio 4.41, P = .002). CONCLUSIONS: Image-guided ablation can achieve local control for adrenal metastases < 5 cm.