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Radiofrequenzablation von Lungentumoren

Eine wirklich effektive Therapiemaßnahme?

Effectiveness of radiofrequency ablation of lung tumours

 

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Zusammenfassung

Hintergrund

Die guten Ergebnisse der Radiofrequenzablation (RFA) primärer und sekundärer Lebertumoren haben dazu geführt, dass dieses palliative Therapieverfahren bei vielen Tumoren eingesetzt wird. Bei Lungentumoren gibt es bisher nur wenig Information über den histomorphologischen Effekt dieses thermischen Ablationsverfahrens.

Patienten und Methode

Bei 11 Patienten mit einem NSCLC („non-small-cell lung cancer“) sowie einer Patientin mit der Lungenmetastase eines Urothelkarzinoms wurde nach RFA der Tumor durch eine Lungenlappenresektion entfernt. Die Präparate wurden histologisch sowie immunhistologisch untersucht und das Nekroseausmaß bestimmt.

Ergebnisse

Bei keinem der Tumoren hatte die RFA zu einer vollständigen Tumornekrose geführt. Dies steht im Gegensatz zu einer radiofrequenzabladierten Lebermetastase, die komplett thermisch zerstört werden konnte.

Schlussfolgerung

Die RFA eignet sich nur unzureichend zur Induktion von Komplettnekrosen von Lungentumoren, weswegen der Einsatz als palliatives Therapieverfahren bei diesen Tumoren aus thoraxchirurgischer Sicht äußerst kritisch gesehen werden muss.

Abstract

Background

There has been great success in the treatment of primary and secondary tumours of the liver using radiofrequency ablation (RFA) therapy, resulting in this method being used for other solid tumours such as in the lung. However, concerning lung cancer only few data are available about the histomorphological effects of this method. The aim of this study was to analyse the effects of RFA therapy in tumours of the lung.

Patients and Methods

Eleven patients with non-small-cell lung cancer and one with a lung metastasis (primary tumour identified as urothelial carcinoma) underwent RFA therapy followed by resection of the affected lobe. One patient with a metastasis of the liver was included for comparison of treatment effects. Histomorphological analysis of the collected material was used to measure the amount of necrosis.

Results

None of the treated tumours of the lung showed complete necrosis after applying RFA therapy. In contrast, this method with the control metastasis of the liver resulted in complete thermal destruction.

Conclusion

Our results indicate that RFA therapy is not adequate for successful induction of necrosis in tumours of the lung. Therefore the use of this method has to be considered extremely carefully as a palliative treatment option in tumours of the lung.

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Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral-, Thorax- und Endokrine Chirurgie, Florence-Nightingale-Krankenhaus, Kreuzbergstraße 79, 40489, Düsseldorf, Deutschland

    K.-H. Schultheis, R. Schroeder-Finckh & A. Schultheis

  2. Pneumonologische Klinik , Florence-Nightingale-Krankenhaus Düsseldorf, Düsseldorf, Deutschland

    R. Kappes

  3. Institut für Pathologie , Ruhr-Universität Bochum, Bochum, Deutschland

    F. Sommerer & A. Tannapfel

Authors
  1. K.-H. Schultheis
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  2. R. Schroeder-Finckh
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  3. A. Schultheis
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  4. R. Kappes
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  5. F. Sommerer
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  6. A. Tannapfel
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Corresponding author

Correspondence to K.-H. Schultheis.

Additional information

Den Herren Prof. Dr. Müller und Dr. Stachewski, Institut für Pathologie der Ruhr-Universität Bochum, sei für die anfänglichen histologischen Untersuchungen gedankt.

Herrn Prof. Dr. E. Hoffmann, Wuppertal zum 80. Geburtstag.

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Schultheis, KH., Schroeder-Finckh, R., Schultheis, A. et al. Radiofrequenzablation von Lungentumoren. Chirurg 79, 963–970 (2008). https://doi.org/10.1007/s00104-008-1493-y

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