Hepatectomy and lung radiofrequency ablation for hepatic and subsequent pulmonary metastases from colorectal carcinoma

Background: Lung radiofrequency ablation (RFA) is a relatively safe procedure and may have a useful role in the management of non-surgical candidates with colorectal pulmonary metastases. Methods: This study consisted of 30 patients, who had previously undergone hepatectomy for colorectal liver metastases and subsequently developed pulmonary metastases, which were then treated with lung RFA. Lung RFA was performed percutaneously under local anesthesia and conscious sedation. The primary aim of this article was to demonstrate the survival outcome in this particular patient population after lung RFA. The secondary aim was to assess the prognostic indicators for survival after lung RFA. Results: The median survival after lung RFA was 32 months, with 3-year survival rate of 45%. The following four factors were found to significantly influence survival in univariate analysis: size of the largest pulmonary metastasis (P = 0.032), proximity of metastases to major pulmonary vessels (P = 0.003), pre-lung RFA CEA levels (P = 0.013) and post-lung RFA CEA levels (P = 0.022). Conclusions: Lung RFA may have a useful role in the management of non-surgical candidates with colorectal pulmonary metastases.