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Percutaneous laser ablation in the lung is an effective and safe procedure. Our results show 1-, 3-, and 5-year survivals of 81%, 44%, and 27%, respectively, for patients after definite ablative therapy of their pulmonary metastatic disease. These data are within the range of results after radiofrequency ablation (Yamakado et al. J Vasc Interv Radiol 18:393–398, 2007; Chua et al. 2010; Zhong et al. 2020) and surgical results from local resection of lung metastases (McCormack et al. Arch Surg 127:1403–1406, 1992; Baron et al. Presse Med 27:885–888, 1998; Friedel et al. Zentralbl Chir 124:96–103, 1999; Inoue et al. Ann Thorac Surg 70:380–383, 2000; Pfannschmidt et al. Ann Thorac Surg 74:1653–1657, 2002 (Table 1)). Our own results showed no significant increase in incidence of periprocedural complications compared with daily routine diagnostic lung biopsies (Weigel et al. Radiologe 44:700, 2004; Rosenberg et al. Am J Roentgenol 92:785–792, 2009). Mortality is negligible compared with thoracotomy. However, one has to be aware of reported cases of central embolism in patients who underwent radiofrequency ablation of pulmonary metastases (Yamamoto et al. Am J Roentgenol 183:1785–1789, 2004; Ghaye et al. Am J Roentgenol 187:W327–328, 2006; Hiraki et al. 2007a,b). Aberrant current or uncontrolled heat proliferation in contrast to radiofrequency-based ablational concepts has never been a challenge in laser-induced thermal therapy. To date, published data on thermal ablation in the lung have become disease-specific. Other than a decade ago and leaving the feasibility stage, it is strictly differentiated between study cohorts suffering from primary or secondary malignancies. Outcome evaluation for metastatic disease is getting more and more entity-specific. Unfortunately, there is a lack of prospectively randomized studies regarding laser ablation, while recent data are focusing on radiofrequency and microwave ablation. Nevertheless, LA of primary and secondary malignant tumors in the lung is a promising option in multimodal cancer therapy.

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Laser Ablation: Lung

  • 章节

  • 发表日期：

    2025年

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  • Christian Rosenberg

摘要

Percutaneous laser ablation in the lung is an effective and safe procedure. Our results show 1-, 3-, and 5-year survivals of 81%, 44%, and 27%, respectively, for patients after definite ablative therapy of their pulmonary metastatic disease. These data are within the range of results after radiofrequency ablation (Yamakado et al. J Vasc Interv Radiol 18:393–398, 2007; Chua et al. 2010; Zhong et al. 2020) and surgical results from local resection of lung metastases (McCormack et al. Arch Surg 127:1403–1406, 1992; Baron et al. Presse Med 27:885–888, 1998; Friedel et al. Zentralbl Chir 124:96–103, 1999; Inoue et al. Ann Thorac Surg 70:380–383, 2000; Pfannschmidt et al. Ann Thorac Surg 74:1653–1657, 2002 (Table 1)). Our own results showed no significant increase in incidence of periprocedural complications compared with daily routine diagnostic lung biopsies (Weigel et al. Radiologe 44:700, 2004; Rosenberg et al. Am J Roentgenol 92:785–792, 2009). Mortality is negligible compared with thoracotomy. However, one has to be aware of reported cases of central embolism in patients who underwent radiofrequency ablation of pulmonary metastases (Yamamoto et al. Am J Roentgenol 183:1785–1789, 2004; Ghaye et al. Am J Roentgenol 187:W327–328, 2006; Hiraki et al. 2007a,b). Aberrant current or uncontrolled heat proliferation in contrast to radiofrequency-based ablational concepts has never been a challenge in laser-induced thermal therapy. To date, published data on thermal ablation in the lung have become disease-specific. Other than a decade ago and leaving the feasibility stage, it is strictly differentiated between study cohorts suffering from primary or secondary malignancies. Outcome evaluation for metastatic disease is getting more and more entity-specific. Unfortunately, there is a lack of prospectively randomized studies regarding laser ablation, while recent data are focusing on radiofrequency and microwave ablation. Nevertheless, LA of primary and secondary malignant tumors in the lung is a promising option in multimodal cancer therapy.