Effectiveness and Safety of CT-guided Percutaneous Radiofrequency Ablation of Adrenal Metastases

The imaging-guided percutaneous radiofrequency (RF) ablation of adrenal metastases is a relatively new treatment procedure, compared to the more widespread application of the technique for the treatment of liver and renal cancers, the present study aims to evaluate the safety and efficacy of the computed tomography (CT)-guided percutaneous radiofrequency ablation of adrenal metastases in a cohort of patients.

Thirty-three patients with 38 adrenal metastases who received percutaneous CT-guided radiofrequency ablation between 2012 to 2015 were retrospectively reviewed. The average diameter of the treated adrenal metastases was 3.0±1.6 cm. The treatment outcomes, including presence of residual tumors, technical success rate, recurrence rate, and complications, were evaluated. Patients were followed up for every 3 months to monitor the progression of the disease.

Postoperative CT images showed the lack of tumor enhancement in 30 tumors (30/38 tumors, technical success rate = 78.9%), and residual disease was found in 7 tumors (7/37 tumors, 18.9%). The rate of residual disease was significantly lower in the group with tumor size < 3cm than the group with tumor size ≥ 3 cm (p = 0.025). The severe complication rate was 4.3%, and the mild complication rate was 48%, with intraoperative hypertensive crisis as the most frequently observed complication (27.3%). The follow-up data showed that 76.3% of patients had recurrence-free survival in 27.4 months.

The current study demonstrated that radiofrequency ablation is a relatively safe and effective treatment for controlling adrenal metastases, especially for patients with tumor size < 3cm. Advances in knowledge: Surgical resection of the adrenal metastases was advocated as one of the treatment options for patients. The present study showed that radiofrequency ablation is a relatively safe and effective treatment for controlling adrenal metastases.

The British journal of radiology. 2018 Jan 19 [Epub ahead of print]

Kang Zhou, Jie Pan, Ning Yang, Hai-Feng Shi, Jian Cao, Yu-Mei Li, Hong-Zhi Zhang, Ke-Fei Wang, Shao-Hui Chen

1 Department of Radiology, Peking Union Medical College Hospital, Beijing, China., 2 Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.