Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma: efficacy and safety of radiofrequency ablation and cryoablation therapy
| Autor: | Thomas D. Atwell, William F. Young, Thomas C. Wass, J.F. McBride, Matthew R. Callstrom, William J. Charboneau |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Time Factors Radiofrequency ablation medicine.medical_treatment Minnesota Adrenal Gland Neoplasms Hemodynamics Pain Pheochromocytoma Cryosurgery law.invention Paraganglioma Young Adult law medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies business.industry Retrospective cohort study Cryoablation Middle Aged medicine.disease Ablation Surgery Treatment Outcome Hypertension Catheter Ablation Disease Progression Female Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed |
| Zdroj: | Journal of vascular and interventional radiology : JVIR. 22(9) |
| ISSN: | 1535-7732 |
| Popis: | Purpose To evaluate the safety and efficacy of percutaneous ablation methods for the treatment of metastatic pheochromocytomas (PCCs) and paragangliomas (PGLs). Materials and Methods From May 2001 to November 2009, 10 patients (mean age 45 years) with metastatic PCCs and PGLs were identified and treated with percutaneous ablation. All patients were given appropriate medication before the ablation procedure. Vital signs were monitored before, during, and after the procedure. There were 47 tumor ablations performed using radiofrequency (RF) ablation, cryoablation, or ethanol injection as determined by tumor location. Results In all patients, all metastatic lesions amendable to percutaneous ablation were treated; for 2 of 10 patients, all known metastases were treated. Successful ablation without evidence of recurrence was achieved in 56% (15 of 27) of primarily treated lesions in patients with available follow-up imaging. The time to disease progression after ablation was 7.2 months ± 4.0. Amelioration of breakthrough hypertensive symptoms or metastasis-related pain was achieved in two of two patients and four of four patients, respectively, at clinical follow-up. Comparison of intra-arterial blood pressure before, during, and after the procedures showed statistically significant differences in these median blood pressures ( P = .004–.05). Major complications occurred after 2 of 18 (11%) ablation sessions, including one unplanned increase in level of patient care and one periprocedural death from complications related to bowel perforation. Conclusions Local control of metastatic PCCs and PGLs with percutaneous ablation can play an important role in disease management when the lesions are unresectable surgically, and there is potential for prolongation of patient function or amelioration of metastasis-related symptoms. |
| Databáze: | OpenAIRE |
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