Risk factors for local tumor progression after RFA of pulmonary metastases: a matched case-control study

Najafi, Arash; Baère, Thierry De; Purenne, Edouard; Bayar, Mohamed Amine; Ahmar, Marc Al; Delpla, Alexandre; Roux, Charles; Madani, Khaled; Assouline, Jessica; Deschamps, Frédèric; Tselikas, Lambros

doi:10.1007/s00330-020-07675-y

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…Also, IAH was associated with a higher risk of local recurrence, which reached significance in the univariate analysis, likely because of the increasing difficulties in locating the target nodule in the background of the dense and radiopaque zone. In addition, the heat sink effect was associated with a higher risk of incomplete ablation for tumors with blood vessel contact resulting from the blood flow and microscopic extension ( 12 , 70 , 71 ). However, our variables relating to vessels did not reach significance, probably with the influence caused by the enrolled cases close to the mediastinum.…”

Section: Discussionmentioning

confidence: 99%

A CT-based radiomics approach to predict immediate response of radiofrequency ablation in colorectal cancer lung metastases

et al. 2023

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ObjectivesTo objectively and accurately assess the immediate efficacy of radiofrequency ablation (RFA) on colorectal cancer (CRC) lung metastases, the novel multimodal data fusion model based on radiomics features and clinical variables was developed.MethodsThis case-control single-center retrospective study included 479 lung metastases treated with RFA in 198 CRC patients. Clinical and radiological data before and intraoperative computed tomography (CT) scans were retrieved. The relative radiomics features were extracted from pre- and immediate post-RFA CT scans by maximum relevance and minimum redundancy algorithm (MRMRA). The Gaussian mixture model (GMM) was used to divide the data of the training dataset and testing dataset. In the process of modeling in the training set, radiomics model, clinical model and fusion model were built based on a random forest classifier. Finally, verification was carried out on an independent test dataset. The receiver operating characteristic curves (ROC) were drawn based on the obtained predicted scores, and the corresponding area under ROC curve (AUC), accuracy, sensitivity, and specificity were calculated and compared.ResultsAmong the 479 pulmonary metastases, 379 had complete response (CR) ablation and 100 had incomplete response ablation. Three hundred eighty-six lesions were selected to construct a training dataset and 93 lesions to construct a testing dataset. The multivariate logistic regression analysis revealed cancer antigen 19-9 (CA19-9, p<0.001) and the location of the metastases (p< 0.05) as independent risk factors. Significant correlations were observed between complete ablation and 9 radiomics features. The best prediction performance was achieved with the proposed multimodal data fusion model integrating radiomic features and clinical variables with the highest accuracy (82.6%), AUC value (0.921), sensitivity (80.3%), and specificity (81.4%).ConclusionThis novel multimodal data fusion model was demonstrated efficient for immediate efficacy evaluation after RFA for CRC lung metastases, which could benefit necessary complementary treatment.

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Section: Discussionmentioning

confidence: 99%

A CT-based radiomics approach to predict immediate response of radiofrequency ablation in colorectal cancer lung metastases

et al. 2023

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“…The ablative margin is also key to improving complete ablation and reducing postprocedural progression. When the ablative margin beyond the tumor was ≥5 mm (ideally 10 mm), complete ablation was significantly higher than that of a tumor with an ablative margin of <5 mm; local progression was also significantly lower than that of a tumor with an ablative margin of <5 mm 27 . However, excessive ablation may occur if the ablative margin is emphasized too much.…”

Section: Limitations and Prospectsmentioning

confidence: 97%

“…When the ablative margin beyond the tumor was ≥5 mm (ideally 10 mm), complete ablation was significantly higher than that of a tumor with an ablative margin of <5 mm; local progression was also significantly lower than that of a tumor with an ablative margin of <5 mm. 27 However, excessive ablation may occur if the ablative margin is emphasized too much. An ablative margin beyond the tumor of >10 mm can aggravate lung parenchymal injury and cause more complications.…”

Section: Limitations and Prospectsmentioning

confidence: 99%

Issues and prospects of image‐guided thermal ablation in the treatment of primary and metastatic lung tumors

Wang

Wei

2022

Thoracic Cancer

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The precise local minimally invasive or noninvasive treatment represents the important orientation for advancing the treatment of pulmonary malignant tumors. New local treatment methods have emerged as solutions to the shortcomings of minimally invasive or local treatment methods. Image‐guided thermal ablation (IGTA) comes with the characteristics such as more accurate localization, less trauma, more definite efficacy, higher safety, stronger repeatability, fewer complications, and lower cost in treating lung tumors. This paper investigates the existing problems of IGTA in the treatment of lung tumors and puts forward the orientation of studies.

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“…Authors also favored TA over stereotactic ablative radiotherapy (SABR) for 2-3 cm oligometastatic lesions in these high-risk patients, notably due to its better safety profile for pulmonary function [30]. However, TA has its own complications and limitations, in particular regarding tumor size and location [31], underlining the need for careful patient selection.…”

Section: Indications Of Thermal Ablationmentioning

confidence: 99%

“…Local tumor control has also been shown to be associated with the absence of contact with a large vessel or a large bronchus [85,86] and complete coverage of tumor by the ablation zone with a margin of 5-10 mm [87,88]. In a matched case-control study [31], 48 patients with first local tumor progression after RFA were matched to a control group of 112 patients to control for nodule size (±5 mm tolerance), nodule number (≤2 vs. ≥3), and primary histological type (categories: colon, rectum, other). In the multiple regression model, only an ablation margin ≤5 mm remained a risk factor of local tumor progression.…”

Section: Local Efficacy and Predictors Of Recurrencementioning

confidence: 99%

Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy

Ghosn

Solomon

2021

Cancers

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A growing body of evidence shows improved overall survival and progression-free survival after thermal ablation in non-small cell lung carcinoma (NSCLC) patients with a limited number of metastases, combined with chemotherapy or tyrosine kinase inhibitors or after local recurrence. Radiofrequency ablation and microwave ablation are the most evaluated modalities, and target tumor size <3 cm (and preferably <2 cm) is a key factor of technical success and efficacy. Although thermal ablation offers some advantages over surgery and radiotherapy in terms of repeatability, safety, and quality of life, optimal management of these patients requires a multidisciplinary approach, and further randomized controlled trials are required to help refine patient selection criteria. In this article, we present a comprehensive review of available thermal ablation modalities and recent results supporting their use in oligometastatic and oligoprogressive NSCLC disease along with their potential future implications in the emerging field of immunotherapy.

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Risk factors for local tumor progression after RFA of pulmonary metastases: a matched case-control study

Cited by 14 publications

References 26 publications

A CT-based radiomics approach to predict immediate response of radiofrequency ablation in colorectal cancer lung metastases

A CT-based radiomics approach to predict immediate response of radiofrequency ablation in colorectal cancer lung metastases

Issues and prospects of image‐guided thermal ablation in the treatment of primary and metastatic lung tumors

Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy

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