Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone-producing adenoma

Yang, Min-Hsin; Tyan, Yeu–Sheng; Huang, Yu-Hui; Wang, Shao-Chuan; Chen, Sung‐Lang

doi:10.1007/s11547-016-0662-1

Cited by 35 publications

(12 citation statements)

References 34 publications

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“…Yang et al . [ 17 ] compared laparoscopic adrenalectomy (LA) to RFA and concluded that treatment success rate reached 100% in the RFA group versus 94.4% in the LA group during 6-month follow-up. RFA group demonstrated less postoperative pain (visual analog scale: 2.00 ± 1.16 vs. 4.22 ± 1.44, P < 0.001) and shorter operative time (105 ± 34 min vs. 194 ± 58 min, P < 0.001) compared with LA group.…”

Section: Discussionmentioning

confidence: 99%

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Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small Cell Lung Cancer

Botsa

Thanou

Papatheodoropoulou

et al. 2017

Chinese Medical Journal

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Background:Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients. However, not all patients can undergo surgery; thus, minimally invasive ablation procedures such as radiofrequency ablation (RFA) and microwave ablation (MWA) have gained acceptance as alternative treatment methods. This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography (CT)-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer (NSCLC).Methods:The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology, General Hospital Sotiria, were retrospectively analyzed. Patients were divided into two groups: RFA group and MWA group according to the therapeutic approaches. Preprocedural blood tests included measurement of international normalized ratio, partial thromboplastin time, and platelet enumeration. A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications. Follow-up was performed with CT or magnetic resonance imaging at 1, 3, 6 months and 1 year after ablation and every 6 months thereafter.Results:A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis. Self-limited, postablation syndrome occurred in 16/99 (16.1%) of ablation sessions. All procedures were technically successful. Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients. Follow-up imaging at 3 months revealed local tumor progression in 8 (22.8%) patients of the RFA group and 7 (19.4%) patients of MWA group, all of them underwent a second session successfully. The 1-year assessment revealed local recurrence of the ablated tumor in six patients (17.1%) of RFA group and seven patients (19.4%) of MWA group. Among these 71 patients, those with tumor size >3.5 cm had a higher local recurrence rate (65.2%, 15/23) than those with tumors ≤3.5 cm (16.7%, 8/48; P = 0.012). There was no significant difference in the median survival time between RFA (14.0 months) and MWA (14.6 months) groups (P > 0.05).Conclusions:RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.

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Section: Discussionmentioning

confidence: 99%

“…RFA group demonstrated less postoperative pain (visual analog scale: 2.00 ± 1.16 vs. 4.22 ± 1.44, P < 0.001) and shorter operative time (105 ± 34 min vs. 194 ± 58 min, P < 0.001) compared with LA group. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small Cell Lung Cancer

Botsa

Thanou

Papatheodoropoulou

et al. 2017

Chinese Medical Journal

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“…Szejnfeld et al performed RFA on 9 patients with Conn syndrome, and 8 of the patients experienced a significant decrease in aldosterone and blood pressure. A study by Yang et al [10] compared RFA to laparoscopic adrenalectomy for benign aldosterone-producing adenomas. Patients treated with RFA experienced comparable normalization in aldosterone and blood pressure with less postoperative pain and shorter operative times.…”

Section: Discussionmentioning

confidence: 99%

Transarterial embolization of a hyperfunctioning aldosteronoma in a patient with bilateral adrenal nodules

Salsamendi

Gortes

Ayala

et al. 2017

Radiology Case Reports

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Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. The patient presented with a cerebrovascular accident, and subsequently developed uncontrolled hypertension, hypokalemia, and a myocardial infarction. Following TAE, potassium returned to normal levels and blood pressure control was improved. There were no postoperative complications. TAE thus may be a safe and effective alternative to surgery.

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“…With RFA, it is not possible to distinguish this scenario from lack of cure due to incomplete nodule ablation. In the studies evaluating RFA in PA, repeat CT imaging was used to reassess the ablated nodule post RFA [8,[12][13][14][15][16]. The absence of intravenous contrast enhancement at the location of the nodule was used to judge complete ablation.…”

Section: Judgement Of Complete Ablationmentioning

confidence: 99%

“…There are several studies investigating RFA as a therapy for PA and are summarised in Table 1, some reporting before the widespread adoption by the international PA community of the PASO criteria making comparisons difficult [8,9,12,13,15,18,19]. They are all of modest size (the largest is 36 participants in the RFA arm) and the comparison studies with adrenalectomy are all non-randomised and retrospective in nature.…”

Section: Evidencementioning

confidence: 99%

Radiofrequency Ablation in Primary Aldosteronism

Lee

Drake

2023

Exp Clin Endocrinol Diabetes

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Radiofrequency ablation (RFA) is a technique that has been extensively used in the treatment of primary malignancies and metastases and, recently, been deployed for the treatment of unilateral Primary Aldosteronism (PA) as an alternative to whole unilateral adrenalectomy. Current evidence comparing RFA with unilateral adrenalectomy in the treatment of PA so far has been variable, with studies being retrospective and small scale, but it remains a very attractive option as a potentially less invasive treatment option compared to adrenalectomy. This review article describes the procedure, the evidence and the possible future direction of RFA in the treatment of unilateral PA.

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Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone-producing adenoma

Abstract: CT-guided percutaneous RFA is effective, safe and is a justifiable alternative for patients who are reluctant or unfit for laparoscopic surgery for the treatment of APA.

Cited by 35 publications

References 34 publications

Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small Cell Lung Cancer

Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small Cell Lung Cancer

Transarterial embolization of a hyperfunctioning aldosteronoma in a patient with bilateral adrenal nodules

Radiofrequency Ablation in Primary Aldosteronism

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