Doctors from Japan have successfully treated post surgery recurrence of Malignant Pleural Mesothelioma (MPM). They used Radiofrequency ablation (RFA) to kill the recurrent tumor cells. The report of the case study was published on the journal “The Annals of Thoracic Surgery”. The doctors involved in the treatment were Akifumi Nakamura, Teruhisa Takuwa, Masaki Hashimoto, Nobuyuki Kondo, Haruyuki Takaki, Masayuki Fujiwara, Koichiro Yamakado and Seiki Hasegawa from Hyogo College of Medicine, Japan.
RFA is an effective and minimally invasive electrosurgical technique involving the use of heat to kill cancer cells. Doctors had to choose RFA due to difficult location of cancer but the result that showed up was promising. “It shows promising efficacy,” the authors wrote. “Radiofrequency should be considered an option for treating recurrence of Malignant Pleural Mesothelioma”.
Malignant Pleural Mesothelioma is an aggressive tumor with limited treatment options, often linked to asbestos exposure. Pleural Mesothelioma has poor prognosis and minimal life expectancy due to chemo-resistance. Mesothelioma recurrence after surgery and lack of response to other modalities of treatment often poses clinical challenges in decision making.
RFA has been considerably utilized over several years for the treatment of inoperable thoracic lesions and hepatic tumors. However, the authors of the study believe this to be the first time it worked effectively with mesothelioma cancer cells. In RFA, high-frequency electrical currents are passed through an electrode in the needle, creating a small region of heat to kill cancer cells.
Patient Profile & Treatment Summary
A 55-year-old man, known case of malignant pleural mesothelioma with right sided pleural effusion came for a follow up 2 years back. He had already undergone variety of treatment options including surgery, chemotherapy and radiation. During the follow up, Contrast Enhanced CT (CECT) of the chest was advised. The CECT film revealed a new tumor in left hemithorax suggestive of focal distant metastasis. Chemotherapy was then administered intravenously with pemetrexed and cisplatin regimen. However, there was no response to treatment even after completing four cycles.
Team of doctors in the Cancer Board of Hyogo College of Medicine therefore had to think of the most suitable approach. The board contemplated that surgery could be a problematic procedure due to poor performance status of patient, past history of treatment failures and difficult location of recurrent tumor. Radiofrequency Ablation (RFA) was then the most suitable option on the list with its safety, effectiveness and low rate of complications. The advantageous ability of RFA to be repeated with recurrent tumors was also considered in the decision making process.
Doctors performed RFA under CT fluoroscopic guidance. Prior to exposing the tumor with an electrode, the internal mammary artery was embolized to prevent risk of bleeding. After exposing the electrode into the center of tumor cells, the energy of radiofrequency was applied for 10 minutes to kill recurrent tumor cells. The procedure was successful with no complications. Post procedure course was uneventful. There was no evidence of Mesothelioma recurrence in the patient even after two years of procedure.