Computed Tomography-Guided Cryoablation for Adrenal Metastasis Secondary to Non-small-cell Lung Cancer

Abstract

Background: Computed tomography (CT)-guided ablation has been used to treat adrenal metastasis (AM). However, the incidence of AM secondary to non-small-cell lung cancer (NSCLC) has not been investigated. Objectives: To assess the clinical efficacy of CT-guided cryoablation for treating AM secondary to NSCLC. Methods: This retrospective study was performed among patients with AM secondary to NSCLC, undergoing CT-guided cryoablation in our hospital. The rates of complete ablation, local recurrence, local recurrence-free survival (RFS), systematic RFS, and overall survival (OS) were also analyzed. Results: Thirty-four consecutive patients with AM secondary to NSCLC (16 cases of squamous cell carcinoma [SCC] and 18 cases of adenocarcinoma) underwent cryoablation in our hospital. The primary complete ablation rates were 93.8% and 88.9% in the SCC and adenocarcinoma groups, respectively (P = 1.000). Moderate blood pressure increases were observed in 7/34 (20.6%) patients during cryoablation. The local recurrence of AM was observed in five and three patients in the SCC and adenocarcinoma groups, respectively (P = 0.551). The median local RFS was 22 months in all patients, and there was no significant difference in terms of the local RFS between the SCC and adenocarcinoma groups (38 vs. 17 months) (P = 0.093). The median systematic RFS was 28 months in all patients, and the systematic RFS was significantly longer in the SCC group as compared to the adenocarcinoma group (56 vs. 19 months) (P = 0.001). The median OS was 34 months in all patients; it was significantly higher in the SCC group as compared to the adenocarcinoma group (56 vs. 22 months) (P = 0.009). Conclusion: CT-guided cryoablation can be a safe and effective treatment to control AM secondary to NSCLC.

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

“…In total, 15 articles were included in this meta-analysis [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], all of which were retrospective (Table I). These studies included 538 patients with 562 AMs who underwent treatment via imaging-guided PA. Of these 15 articles, 8 employed radiofrequency ablation (RFA) [14-16, 18, 20, 22, 25, 26], 5 employed cryoablation (CA) [12,13,17,23,24], and 2 employed microwave ablation (MWA) [19,21]. In addition, 10 studies employed CT guidance [12,13,15,19,20,[22][23][24][25][26], while 5 employed US guidance [14,[16][17][18]21].…”

“…In addition, 10 studies employed CT guidance [12,13,15,19,20,[22][23][24][25][26], while 5 employed US guidance [14,[16][17][18]21]. Of these studies, 9 included patients with multiple primary cancers [12,14,15,17,18,21,23,25,26], while 3 included patients with AMs secondary to lung cancer (LC) [13,19,24], and 3 studies enrolled individuals with AMs secondary to hepatocellular carcinoma (HCC) [16,20,22]. All articles reported NOS scores in the range 7-8.…”

“…Local recurrence rates were reported in 12 studies [12,13,[15][16][17][18][19][22][23][24][25][26], with a pooled local recurrence rate of 19% (95% CI: 0.15-0.23, Figure 2 F). This endpoint was associated with low levels of heterogeneity (I 2 = 0%, p = 0.87), as well as a low risk of publication bias (Egger's test: p = 0.744).…”

“…Three studies focused on patients with primary LC [13,19,24]. The pooled rates of primary technical success, local hemorrhage, hypertensive crisis, local recurrence, 1-year OS, and 3-year OS were 93% (95% CI: 0.88-0.98), 3% (95% CI: -0.03-0.09), 6% (95% CI: -0.02-0.14), 22% (95% CI: 0.14-0.30), 79% (95% CI: 0.71-0.88), and 53% (95% CI: 0.38-0.69), respectively (Table V).…”

Contrast-Enhanced Chest Computed Tomography (CT) Scan with Low Radiation and Total Iodine Dose for Lung Cancer Detection Using Adaptive Statistical Iterative Reconstruction

“…Due to the use of this modality, lung cancer mortality has reduced by 20% (3,4) Overall, contrast-enhanced chest CT scan can clearly represent the blood supply and small lesions. The iodine concentration in pulmonary nodules directly reflects the blood supply to nodules (5), which can be helpful for the clinical diagnosis and timely treatment of lung cancer (6).…”