Computed tomography-guided cryoablation for adrenal metastases secondary to lung cancer

J Cancer Res Ther. 2021 Nov;17(5):1269-1274. doi: 10.4103/jcrt.JCRT_1520_20.

Abstract

Objectives: The objective of the study was to assess the clinical efficacy of computed tomography (CT)-guided cryoablation as a means to treat adrenal metastasis (AM) secondary to lung cancer.

Materials and methods: This study was a single-center retrospective study that analyzed 39 consecutive patients with AM secondary to lung cancer who underwent CT-guided cryoablation in our center. The rates of complete ablation, local recurrence, local recurrence-free survival (RFS), and overall survival (OS) were analyzed.

Results: The rates of primary and secondary complete ablation were 94.9% and 100%, respectively, and none of the patients suffered from a hypertensive crisis associated with the treatment. Over the follow-up period, 20.5% of the patients experienced local recurrence, and the median RFS duration was 26 months. The cumulative 1-, 3-, and 5-year local RFS rates in this study were 84.6%, 51.3%, and 5.9%, respectively. Extra-adrenal gland metastases were detected in five patients. Over the course of follow-up, 26 patients died. The mean OS duration was 34 months with cumulative 1-, 3-, and 5-year OS rates of 89.7%, 53.4%, and 8.3%, respectively. Advanced age (P = 0.001), primary adenocarcinoma (P = 0.006), other primary lung cancers (P = 0.038), and primary Stage III lung cancers (P = 0.007) were all found to be independent predictive factors of poor OS in these patients.

Conclusion: CT-guided cryoablation can be safely and effectively used to control AM secondary to lung cancer, and patients with AM secondary to lung squamous cell carcinoma may be best suited for this form of treatment.

Keywords: Adrenal; cryoablation; lung cancer; metastasis; survival.

MeSH terms

  • Adrenal Gland Neoplasms / pathology
  • Adrenal Gland Neoplasms / surgery*
  • Adult
  • Aged
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Catheter Ablation / mortality*
  • Cryosurgery / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasms, Second Primary / pathology
  • Neoplasms, Second Primary / surgery*
  • Prognosis
  • Retrospective Studies
  • Surgery, Computer-Assisted / mortality*
  • Survival Rate
  • Tomography, X-Ray Computed / methods