Sano Yoshifumi, Kanazawa Susumu, Mimura Hidefumi, Gobara Hideo, Hiraki Takao, Fujiwara Hiroyasu, Yamane Masaomi, Toyooka Shinichi, Oto Takahiro, Date Hiroshi
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
J Thorac Oncol. 2008 Mar;3(3):283-8. doi: 10.1097/JTO.0b013e3181645443.
Local treatment that includes surgical resection of metastatic pulmonary tumors is controversial because of the biologic features and invasiveness of these tumors. We report our experience with a premeditated treatment involving combined computed tomography-guided radiofrequency ablation and surgical resection in three patients with metastatic pulmonary tumors.
Three patients underwent radiofrequency ablation in conjunction with surgical resection. The first was a 67-year-old man with pulmonary metastases of bronchial adenoid cystic carcinoma. We performed partial resection of five tumors in the right lung and ablated a tumor in the left lung. The second was a 66-year-old man with pulmonary metastases of renal cell carcinoma. He underwent radiofrequency ablation for three tumors in the right upper and middle lobes, and right lower lobectomy for tumors in that lobe. The third was a 55-year-old man with pulmonary metastases of high-grade sarcoma of the right thigh. We performed partial resection of five tumors in the left lung and ablated a tumor in the right lung.
Two patients had metastatic lesions on both sides of the lung; we performed surgical resection on one side and radiofrequency ablation contralaterally to avoid bilateral thoracotomy. The third patient underwent surgical resection and radiofrequency ablation to avoid highly invasive right pneumonectomy. All patients survived for more than 1(1/2) years after combination therapy.
Premeditated treatment involving a combination of radiofrequency ablation and surgical resection can be a useful option in patients with metastatic pulmonary tumors, improving curability and avoiding highly invasive procedures.
由于转移性肺肿瘤的生物学特性和侵袭性，包括手术切除这些肿瘤的局部治疗存在争议。我们报告了3例转移性肺肿瘤患者采用计算机断层扫描引导下射频消融与手术切除相结合的预先设计治疗的经验。
3例患者接受了射频消融联合手术切除。第一例是一名67岁男性，患有支气管腺样囊性癌肺转移。我们对右肺的5个肿瘤进行了部分切除，并对左肺的1个肿瘤进行了消融。第二例是一名66岁男性，患有肾细胞癌肺转移。他对右上叶和中叶的3个肿瘤进行了射频消融，并对右下叶的肿瘤进行了右下叶切除术。第三例是一名55岁男性，患有右大腿高级别肉瘤肺转移。我们对左肺的5个肿瘤进行了部分切除，并对右肺的1个肿瘤进行了消融。
2例患者双侧肺部有转移灶；我们在一侧进行手术切除，在对侧进行射频消融，以避免双侧开胸手术。第三例患者接受了手术切除和射频消融，以避免高侵袭性的右全肺切除术。所有患者在联合治疗后存活超过1.5年。
射频消融与手术切除相结合的预先设计治疗对于转移性肺肿瘤患者可能是一种有用的选择，可提高治愈率并避免高侵袭性手术。
