Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates

Objective: Cryoablation of pulmonary metastases might be a useful therapy for nonsurgical candidates. Methods: The procedure was performed after achievement of local anesthesia for 35 tumors in 20 patients (12 male and 8 female patients; mean age, 57 years). The primary end point was the safety and feasibility of cryoablation, and the secondary end point was tumor control assessed by follow-up dynamic computed tomographic scanning performed every 3 months. Results: Of the 22 sessions of cryoablation, pneumothorax occurred in 11, hemoptysis occurred in 8, and there was 1 case of phrenic nerve palsy. The mean hospital stay was 2.6 days. There was local recurrence of 7 (20%) tumors in 7 (35%) patients during a 9- to 28-month (median, 21 months) follow-up period. One-year survival according to the Kaplan-Meier method was 89.4%. Conclusion: Percutaneous cryoablation therapy for metastatic lung tumors is feasible and minimally invasive, with satisfactory local control.