Effectiveness and safety of CT-guided percutaneous radiofrequency ablation of adrenal metastases

Zhou, Kang; Pan, Jie; Yang, Ning; Shi, Haifeng; Cao, Jian; Li, Yumei; Zhang, Hongzhi; Wang, Kefei; Chen, Shaohui

doi:10.1259/bjr.20170607

Cited by 22 publications

(43 citation statements)

References 28 publications

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“…As reported in previous studies, patients with AM treated by RFA showed local tumour control rate at 77.2–94% and the median survival time at 14.0–26.0 months, depending on origins of primary tumour [15–18, 23]. In addition, RFA may provide favourable treatment efficacy for ‘oligometastatic’ tumours from HCC.…”

Section: Discussionsupporting

confidence: 52%

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Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

et al. 2019

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Background The prognosis of adrenal metastases (AM) from hepatocellular carcinoma (HCC) with surgical contraindication was poor. This study evaluated the feasibility, safety and treatment efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) for the local treatment of AM originated from HCC. Methods A retrospective study was carried out on 22 patients (21 male and 1 female, mean age, 53.0 ± 13.0 years) who had single AM (mean diameter, 4.0 ± 1.8 cm, range, 1.7–8.0 cm) originated from HCC and received US-guided percutaneous RFA at our institution. The diagnosis was established on typical radiologic findings. The primary technical success was defined as the tumour being completely ablated in the first RFA session. The secondary technical success was defined as tumour residual left from the first ablation was completely ablated by a second ablation session. Local tumour progression (LTP) and overall survival (OS) were estimated by using Kaplan-Meier analysis. Results A total of 25 ablation sessions were performed. The primary technical success and the secondary technical success were 77.3% (17 of 22) and 86.4% (19 of 22), respectively, with the major complication rate at 4.5% (1 of 22). The median follow-up period after RFA was 10 months (3–55 months). During the follow-up period, five patients were detected LTP. The LTP at 3, 6, and 12 months were 15.8, 26.3, and 26.3%, respectively. Nine patients died of distant extra-adrenal metastases and another five of liver failure due to HCC. The OS at 6, 12, 24 months after RFA for AM were at 79.7, 52.6, and 32.9%, respectively. Conclusion Percutaneous US-guided RFA in the treatment of AM originated from HCC is feasible, safe and effective.

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Section: Discussionsupporting

confidence: 52%

“…In addition, many studies have reported that RFA may achieve 77–80% of local tumour control in AMs originated from lung or kidney [15–18]. However, there are few studies focus on RFA for the AMs originated from HCC.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

et al. 2019

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“…Major complications requiring hospital stay or intervention are not common, ranging from 0% to 8.3% (median, 1.5%) [11][12][13][14][15][16][17][18]. Hypertensive crisis is the most common complication during the procedure and rapid increases in BP may complicate cerebrovascular and cardiovascular diseases ( Fig.…”

Section: Complications and Preventionmentioning

confidence: 99%

“…RFA outcomes for treating adrenal metastasis are not as good as those for benign adrenal tumors ( Table 2 ) [ 12 , 13 , 18 , 21 ]. The local control rate ranges from 77% to 80% (median, 78%).…”

Section: Rfa Outcomesmentioning

confidence: 99%

“…Percutaneous thermal ablation is a minimally invasive treatment for liver [1,2], kidney [3,4], lung [5,6], bone [7,8], and thyroid [9,10] tumors in patients who are unable to undergo surgery. This treatment also has been used to treat adrenal tumors in patients who are poor surgical candidates [11][12][13][14][15][16][17][18][19][20][21][22][23]. Thermal ablation techniques for adrenal ablation include radiofrequency ablation (RFA), cryoablation [24,25], and microwave ablation [26,27].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Adrenal Radiofrequency Ablation: A Short Review for Endocrinologists

Park

2020

Endocrinol Metab

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Image-guided radiofrequency ablation (RFA) has been accepted as a minimally invasive treatment for adrenal tumors in patients who are unable to undergo adrenalectomy. Accordingly, this treatment has become more readily available for treating functioning or non-functioning adrenal masses. Thus, endocrinologists need a better understanding of percutaneous RFA of adrenal tumors. The purpose of this review is to briefly describe the basic mechanism of RFA, indications and contraindications, patient preparation prior to RFA, type of complications, how to avoid complications, RFA procedures, and treatment outcomes.

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Efficacy and Safety of Ultrasound‐Guided Percutaneous Ablation for Adrenal Metastases

Zhong

Wang

Liu

et al. 2023

J of Ultrasound Medicine

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Objectives-To assess the efficacy and safety of ultrasound-guided percutaneous ablation (US-PA) for adrenal metastases (AMs) using a meta-analysis.Methods-A systematic search of PubMed, Cochrane, Web of Science, and Embase electronic databases was performed to identify studies on US-PA for AM. Seven studies published between January 2000 and August 2022 were analyzed, which resulted in a sample size of 140 patients. Both random effects and common effects meta-analysis models were used to analyze the following efficacy and safety outcomes: the first and secondary technical success rate, 1-year overall survival rates, 1-year local tumor control rate, incidence rate of intraoperative hypertensive crises, and major complications. The subgroup analysis was performed to explore the origin of heterogeneity.Results-Among 140 patients from 7 studies included in this meta-analysis: 51 (36.43%) underwent radiofrequency ablation (RFA), and 89 (63.57%) underwent microwave ablation (MWA). Pooled data analysis revealed that the first and secondary technical success rates were 85% (95% confidence interval [CI], 73-96) and 99% (95% CI, 96-100), the 1-year overall survival rate was 83% (95% CI, 71-93), the 1-year local tumor control rate was 83% (95% CI, 75-90), and the incidence rate of intraoperative hypertensive crises was 14% (95% CI, 8-20). The overall rate of major complications was 3.6%. In the subgroup analysis, lower heterogeneity was indicated to be associated with mean tumor size and ablation type.Conclusions-This meta-analysis showed that US-PA can be both effective and safe for AM in terms of overall survival, technical success rate, and local control for AM.

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Effectiveness and safety of CT-guided percutaneous radiofrequency ablation of adrenal metastases

Cited by 22 publications

References 28 publications

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience

Percutaneous Adrenal Radiofrequency Ablation: A Short Review for Endocrinologists

Efficacy and Safety of Ultrasound‐Guided Percutaneous Ablation for Adrenal Metastases

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