Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma

Efficacy and safety of radiofrequency ablation and cryoablation therapy

Jeremy F. McBride, Thomas D. Atwell, William J. Charboneau, William Francis Young, Thomas C. Wass, Matthew R Callstrom

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1263-1270
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number9
DOIs
StatePublished - Sep 2011

Fingerprint

Paraganglioma
Cryosurgery
Pheochromocytoma
Safety
Therapeutics
Neoplasm Metastasis
Vital Signs
Disease Management
Disease Progression
Neoplasms
Patient Care
Arterial Pressure
Ethanol
Blood Pressure
Recurrence
Pain
Injections

Keywords

  • PACU
  • paraganglioma
  • PCC
  • PGL
  • pheochromocytoma
  • postanesthesia care unit
  • SD
  • standard deviation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma : Efficacy and safety of radiofrequency ablation and cryoablation therapy. / McBride, Jeremy F.; Atwell, Thomas D.; Charboneau, William J.; Young, William Francis; Wass, Thomas C.; Callstrom, Matthew R.

In: Journal of Vascular and Interventional Radiology, Vol. 22, No. 9, 09.2011, p. 1263-1270.

Research output: Contribution to journalArticle

@article{2e6445ababf1432a8b19a4027d482115,
title = "Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma: Efficacy and safety of radiofrequency ablation and cryoablation therapy",
abstract = "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.",
keywords = "PACU, paraganglioma, PCC, PGL, pheochromocytoma, postanesthesia care unit, SD, standard deviation",
author = "McBride, {Jeremy F.} and Atwell, {Thomas D.} and Charboneau, {William J.} and Young, {William Francis} and Wass, {Thomas C.} and Callstrom, {Matthew R}",
year = "2011",
month = "9",
doi = "10.1016/j.jvir.2011.06.016",
language = "English (US)",
volume = "22",
pages = "1263--1270",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "9",

}

TY - JOUR

T1 - Minimally invasive treatment of metastatic pheochromocytoma and paraganglioma

T2 - Efficacy and safety of radiofrequency ablation and cryoablation therapy

AU - McBride, Jeremy F.

AU - Atwell, Thomas D.

AU - Charboneau, William J.

AU - Young, William Francis

AU - Wass, Thomas C.

AU - Callstrom, Matthew R

PY - 2011/9

Y1 - 2011/9

N2 - 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.

AB - 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.

KW - PACU

KW - paraganglioma

KW - PCC

KW - PGL

KW - pheochromocytoma

KW - postanesthesia care unit

KW - SD

KW - standard deviation

UR - http://www.scopus.com/inward/record.url?scp=80051975164&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051975164&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2011.06.016

DO - 10.1016/j.jvir.2011.06.016

M3 - Article

VL - 22

SP - 1263

EP - 1270

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 9

ER -