A Single-Institution Experience in Image-Guided Thermal Ablation of Adrenal Gland Metastases

作者:Welch Brian T*; Callstrom Matthew R; Carpenter Paul C; Wass C Thomas; Welch Tasha L; Boorjian Stephen A; Nichols Douglas A; Thompson Geoffrey B; Lohse Christine M; Erickson Dana; Leibovich Bradley C; Atwell Thomas D
来源:Journal of Vascular and Interventional Radiology, 2014, 25(4): 593-598.
DOI:10.1016/j.jvir.2013.12.013

摘要

Purpose: To assess safety, technical success, local control, and survival associated with percutaneous image-guided adrenal ablation. Materials and Methods: Adult patients with adrenal metastases who underwent percutaneous image-guided adrenal ablation during the years 2003-2012 were identified. There were 32 patients with 37 adrenal tumors identified. Technical success, safety, local control, and survival were analyzed according to standard criteria. Results: In 32 patients (25 men and 7 women; mean age, 66 y; age range, 44-88 y) with 37 adrenal tumors, 35 ablation procedures were performed. One patient with an 8.2-cm tumor underwent planned cryoablation debulking fully anticipating untreated margins owing to close proximity of the pancreas (ie, the intent was to diminish tumor burden rather than a curative intervention). Of the 36 patients treated with curative intent, technical success was achieved in 35 (97%) tumors. Follow-up imaging was performed on 34 of 37 tumors (excluding patients with intentional debulking [n = 1], technical failure [n = 1], and absence of follow-up [n = 1]). Local recurrence developed in 3 (8.8%) of 34 tumors. Local tumor control was achieved in 31 lesions at a mean of 22.7 months of follow-up. Recurrence-free survival and overall survival at 36 months were 88% and 52%, respectively, with a median survival of 34.5 months. A Common Terminology Criteria for Adverse Events version 4 grade 3 or 4 complication was observed in three (8.6%) ablation procedures. Conclusions: Image-guided ablation is safe and effective for local control of metastatic adrenal tumors and provides a minimally. invasive alternative to surgical resection in appropriately selected patients.

  • 出版日期2014-4