Artificial Pneumothorax Improves Radiofrequency Ablation of Pulmonary Metastases of Hepatocellular Carcinoma close to Mediastinum

Abstract

Background: To investigate the feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of pulmonary metastases from hepatocellular carcinoma (HCC) contiguous with the mediastinum using the artificial pneumothorax technique.Method: A total of 40 lesions in 32 patients with pulmonary metastases from HCC contiguous with the mediastinum accepted RFA treatment from August 2014 to May 2018 via the artificial pneumothorax technique. After ablation, clinical outcomes were followed up by contrast enhanced CT. Technical success, local tumor progression (LTP), intrapulmonary distant recurrence (IDR), and adverse events were evaluated. Overall survival (OS) and local tumor progression free survival (LTPFS) were recorded for each patient. Results: The tumor size was 1.4 ± 0.6 cm in diameter. RFA procedures were all successfully performed without intra-ablative complications. Technical success was noted in 100% of the patients. 5 cases of LTP and 8 cases of IDR occurred following the secondary RFA for treatment. Slight pain was reported in all patients. No major complications were observed. The 1, 2, and 3-year LTPFS rates were 90.6%, 81.2%, and 71.8%, and the 1, 2, and 3-year OS rates were 100%, 100% and 87.5%, respectively.Conclusion: Artificial pneumothorax adjuvant RFA is a feasible, safe, and efficient method for treatment of pulmonary metastases from HCC contiguous with the mediastinum.

Microwave ablation therapy assisted by artificial pneumothorax and artificial hydrothorax for lung cancer adjacent to the vital organs

“…Moreover, artificial pneumothorax is a safe and effective method for pain relief during MWA of subpleural lung tumors ( 17 , 18 ). In addition, artificial pneumothorax or hydrothorax has been used with significant success in thermal ablation of tumors adjacent to lung tissue in the lower lobe or near the diaphragm dome ( 19 – 21 ). In this study, because the lung lesions were adjacent to the vital organs, it was difficult to clearly show the effective puncture path and perform the ablation using a conventional CT scan.…”