Radio-frequency ablation (RFA) has been successfully applied for local control of metastatic
tumor. The aim of this study was to assess the effectiveness and safety of RFA to post-chemotherapeutic metastatic
germ cell tumors (GCTs). As
combined modality therapy, RFA was performed to 42
tumors in 19 patients of GCTs at our institution between November 2000 and December 2008. RFA was performed for 10 liver metastatic
tumors (in 6 cases), 32 lung metastatic
tumors (in 13 cases), and median age was 36 years old (range 20-53) and the median
tumor size was 12 mm (range 2-40). We used Cool-tip RF system (straight
electrode needle of the internal cooling type, Radionics, Palm Coast, USA) for RFA with ultrasound or CT fluorosent guidance under intravenous or
local anesthesia. The
therapeutic effect was assessed by the contrast-enhanced CT or MRI. When contrast enhancement was remained in the
tumor, the treatment was repeated. The 28 evaluable lesions followed were with median 25 months in the term of the surveillance, and 9
tumors were treated by an additional session of RFA repeatedly. complete response (CR) was achieved in 12 out of 12
tumors (100%) with
tumor maker normalization. On the other hand, 12 out of 16
tumors (75%) without marker normalization showed CR. All of the 24
tumors with
tumor diameter of 30 mm or less achieved CR, and the
tumor greater than 30 mm achieved no CR. Major complications included
pneumothorax (n=9) and hemato-thoraxes (n=2), but no complications in surrounding organs. The chest drainage tube was required in 4 cases (36%). RFA might be an alternative therapeutic option of
combined modality therapy as
salvage therapy for post-chemotherapeutic metastatic
germ cell tumors.