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<p>This systematic review synthesizes evidence from 14 studies encompassing 1,639 patients and over 3,000 pulmonary lesions treated with radiofrequency ablation (RFA). The primary objective was to assess the efficacy of radiofrequency ablation in achieving local tumor control (LTC) and improving overall survival (OS) in patients with pulmonary metastases, especially those ineligible for surgery or stereotactic body radiotherapy (SBRT). Secondary outcomes included complication rates.</p><p>Across the studies, local tumor control ranged from 60.7% to 90%, with the highest control observed in small (≤3 cm), peripherally located metastases. Overall survival varied widely, from 24 to 118 months, with colorectal cancer metastases typically achieving median overall survival between 50 and 65 months. Pneumothorax was the most common complication, with rates ranging from 0.5% to 67%; no procedure-related deaths were reported.</p><p>Despite these promising results, most studies had a moderate to serious risk of bias due to retrospective design, lack of control groups, and heterogeneous patient populations. Certainty of evidence was rated low for both local tumor control and overall survival, and low to moderate for complication rates. While meta-analysis was not feasible due to study heterogeneity, visual forest plots were used to illustrate the distribution of key outcomes.</p><p>Overall, radiofrequency ablation appears to be a safe and effective treatment option for carefully selected patients with limited pulmonary metastatic burden. These findings support further prospective, controlled trials comparing radiofrequency ablation to stereotactic body radiotherapy and surgery in well-defined patient cohorts.</p>

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Efficacy and safety of radiofrequency ablation for treatment of lung metastases: a systematic review

  • 期刊论文

  • 发表日期：

    2025年8月19日

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  • Matias Vega,
  • Katharina Bareck,
  • Thomas Niernberger,
  • Herbert Ringhofer,
  • Sabine Gabor

摘要

This systematic review synthesizes evidence from 14 studies encompassing 1,639 patients and over 3,000 pulmonary lesions treated with radiofrequency ablation (RFA). The primary objective was to assess the efficacy of radiofrequency ablation in achieving local tumor control (LTC) and improving overall survival (OS) in patients with pulmonary metastases, especially those ineligible for surgery or stereotactic body radiotherapy (SBRT). Secondary outcomes included complication rates.

Across the studies, local tumor control ranged from 60.7% to 90%, with the highest control observed in small (≤3 cm), peripherally located metastases. Overall survival varied widely, from 24 to 118 months, with colorectal cancer metastases typically achieving median overall survival between 50 and 65 months. Pneumothorax was the most common complication, with rates ranging from 0.5% to 67%; no procedure-related deaths were reported.

Despite these promising results, most studies had a moderate to serious risk of bias due to retrospective design, lack of control groups, and heterogeneous patient populations. Certainty of evidence was rated low for both local tumor control and overall survival, and low to moderate for complication rates. While meta-analysis was not feasible due to study heterogeneity, visual forest plots were used to illustrate the distribution of key outcomes.

Overall, radiofrequency ablation appears to be a safe and effective treatment option for carefully selected patients with limited pulmonary metastatic burden. These findings support further prospective, controlled trials comparing radiofrequency ablation to stereotactic body radiotherapy and surgery in well-defined patient cohorts.