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J Thorac Cardiovasc Surg 2006;131:1007-1013
© 2006 The American Association for Thoracic Surgery

General Thoracic Surgery

Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates

Masafumi Kawamura, MD a , * , Yotaro Izumi, MD a , Norimasa Tsukada, MD a , Keisuke Asakura, MD a , Hiroaki Sugiura, MD b , Hideki Yashiro, MD b , Keiko Nakano, MD b , Seishi Nakatsuka, MD b , Sachio Kuribayashi, MD b , Koichi Kobayashi, MD a

a Division of General Thoracic Surgery, School of Medicine, Keio University, Tokyo, Japan
b Division of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan

Received for publication October 8, 2005; revisions received December 8, 2005; accepted for publication December 22, 2005.

* Address for reprints: Masafumi Kawamura, MD, Division of General Thoracic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan (Email: kawamura{at}sc.itc.keio.ac.jp).

OBJECTIVE: Cryoablation of pulmonary metastases might be a useful therapy for nonsurgical candidates.

METHODS: The procedure was performed after achievement of local anesthesia for 35 tumors in 20 patients (12 male and 8 female patients; mean age, 57 years). The primary end point was the safety and feasibility of cryoablation, and the secondary end point was tumor control assessed by follow-up dynamic computed tomographic scanning performed every 3 months.

RESULTS: Of the 22 sessions of cryoablation, pneumothorax occurred in 11, hemoptysis occurred in 8, and there was 1 case of phrenic nerve palsy. The mean hospital stay was 2.6 days. There was local recurrence of 7 (20%) tumors in 7 (35%) patients during a 9- to 28-month (median, 21 months) follow-up period. One-year survival according to the Kaplan-Meier method was 89.4%.

CONCLUSION: Percutaneous cryoablation therapy for metastatic lung tumors is feasible and minimally invasive, with satisfactory local control.

Abbreviations and Acronyms CT = computed tomography; PD = progressive disease; PR = partial response; RECIST = Response Evaluation Criteria in Solid Tumors; RFA = radiofrequency ablation; SD = stable disease




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