Image-guided radiofrequency ablation for adrenal metastatic tumors: a systematic review and meta-analysis

Figures & data

Table 1. Baseline data of the included studies.

	Year	Country	Patients number	AMT number	Mean age	M/F	Mean diameter	Primary tumors	Mean follow-up	Follow-up methods
Hasegawa [9]	2015	Japan	35	41	64.7 y	25/10	3.3 cm	HCC, LC, RCC, CC, others	30.1 m	CT
Huang [10]	2019	China	22	22	53.0 y	21/1	4.0 cm	HCC	10 m	Not given
Li [11]	2013	China	30	30	64.2 y	22/8	4.2 cm	HCC, LC, RCC, GC, BC	Not given	CT
Liu [12]	2020	China	29	29	52.9 y	25/4	Not given	HCC, LC, RCC, others	24.5 m	CT and US
Liu B [13]	2020	China	16	16	53.3 y	15/1	3.6 cm	HCC	Range: 3-55 m	CT and MRI
Sui [14]	2019	China	70	70	54.4 y	38/32	Not given	HCC	Not given	Not given
Wang [15]	2009	China	19	24	58 y	13/6	3.5 cm	HCC, LC, RCC, CC	10 m	CT
Yuan [16]	2018	China	38	38	54.2 y	26/12	3.3 cm	HCC	26.3 m	CT and MRI
Zhang [17]	2011	China	13	13	59 y	10/3	4.5 cm	HCC	14.2 m	CT
Zhou [18]	2018	China	33	38	60 y	17/16	Not given	HCC, LC, RCC, CC, OC	22.8 m	CT and MRI
Zhou K [19]	2018	China	46	52	64.4 y	28/18	3.31 cm	HCC, LC, RCC, CC, OC	11.5 m	CT and MRI

AMT: adrenal metastatic tumor; BC: breast cancer; CC: colonic cancer; CT: computed tomography; F: female; GC: gastric cancer; HCC: hepatocellular carcinoma; LC: lung cancer; M: male; MRI: magnetic resonance imaging; OC: ovarian cancer; RCC: renal cell carcinoma; RFA: radiofrequency ablation; US: ultrasound.

Figure 1. Study flowchart.

Table 2. Baseline data of the RFA.

	Guidance	RFA devices	Electrode size	Maximum power	Hydro dissection
Hasegawa [9]	CT	Cooltip	Not given	Not given	Yes
Huang [10]	US	Cooltip	17 G	200 W	Yes
Li [11]	US	Valleylab	Not given	150 W	Not mentioned
Liu [12]	US	LeVeen, Starburst XL, Cooltip	Not given	Not given	Yes
Liu B [13]	US	Cooltip	Not given	Not given	Yes
Sui [14]	CT	Not given	Not given	60 W	Not mentioned
Wang [15]	CT	Starburst XL	16 G	150 W	Not mentioned
Yuan [16]	CT	RITA	Not given	Not given	Yes
Zhang [17]	US	Radionic	17.5 G	200 W	Not mentioned
Zhou [18]	CT	CelonLab	Not given	250 W	Not mentioned
Zhou K [19]	CT	CelonLab	Not given	250 W	Not mentioned

CT: computed tomography; RFA: radiofrequency ablation; US: ultrasound.

Table 3. Subgroup analysis of primary technical success rate.

	Studies (n)	Primary technical success rate	95% CI	I^2
Guidance methods
US	5	80%	0.72–0.87	0.0%
CT	6	85%	0.81–0.90	0.0%
Mean diameter
<4 cm	5	86%	0.81–0.91	0.0%
≥4 cm	3	79%	0.70–0.89	0.0%

CI: confidence interval; CT: computed tomography; US: ultrasound.

Table 4. Subgroup analysis of hypertension crisis rate.

	Studies (n)	Hypertension crisis rate	95% CI	I^2
Guidance methods
US	5	7%	0.02–0.12	0.0%
CT	6	6%	0.03–0.09	44.9%
Mean diameter
<4 cm	5	7%	0.03–0.11	55.5%
≥4 cm	3	5%	0.00–0.10	0.0%

CI: confidence interval; CT: computed tomography; US: ultrasound.

Table 5. Subgroup analysis of local recurrence rate.

	Studies (n)	Local recurrence rate	95% CI	I^2
Guidance methods
US	4	21%	0.13–0.29	0.0%
CT	4	18%	0.12–0.25	0.0%
Mean diameter
<4 cm	4	17%	0.10–0.24	0.0%
≥4 cm	2	20%	0.09–0.31	0.0%

CI: confidence interval; CT: computed tomography; US: ultrasound.

Hasegawa T, Yamakado K, Nakatsuka A, et al. Unresectable adrenal metastases: clinical outcomes of radiofrequency ablation. Radiology. 2015;277(2):584–593.

 PubMed Web of Science ®Google Scholar

Huang J, Xie X, Lin J, et al. Percutaneous radiofrequency ablation of adrenal metastases from hepatocellular carcinoma: a single-center experience. Cancer Imaging. 2019;19(1):44.

 PubMedGoogle Scholar

Li D, Huang J, Wang Y, et al. Percutaneous radiofrequency ablation treatment in adrenal metastasis tumors by ultrasound-guided unipola cooling cycle. Chin J Ultrasound Med. 2013;29:806–809.

 Google Scholar

Liu B, Mo C, Wang W, et al. Treatment outcomes of percutaneous radiofrequency ablation versus adrenalectomy for adrenal metastases: a retrospective comparative study. J Endocrinol Invest. 2020;43(9):1249–1257.

 PubMed Web of Science ®Google Scholar

Liu B, Lei Y, Tan Y, et al. Efficiency and safety of percutaneous ultrasound-guided radiofrequency ablation for right adrenal metastases from hepatocellular carcinoma. Chin J Ultrasonogr. 2020;29:149–152.

 Google Scholar

Sui S, Lu J, Wu G, et al. TACE combined with RFA for adrenal metastasis from HCC: curative effect and prognosis. J Intervent Radiol. 2019;28:837–841.

 Google Scholar

Wang Z, Fu W, Lu Z, et al. CT-guided percutaneous radiofrequency ablation for the treatment of metastatic adrenal malignancies: the initial results. J Intervent Radiol. 2009;5:340–343.

 Google Scholar

Yuan H, Liu F, Li X, et al. Clinical efficacy of chemoembolization with simultaneous radiofrequency ablation for treatment of adrenal metastases from hepatocellular carcinoma. Cancer Imaging. 2018;18(1):24.

 PubMedGoogle Scholar

Zhang J, Yu Y, Song H, et al. TACE combined with RFA for adrenal metastasis from HCC. Shi Yong Zhong Liu Xue Za Zhi. 2011;25:461–465.

 Google Scholar

Zhou K, Pan J, Yang N, et al. Effectiveness and safety of CT-guided percutaneous radiofrequency ablation of adrenal metastases. Br J Radiol. 2018;91:20170607.

 PubMed Web of Science ®Google Scholar

Zhou K, Shi H. Radiofrequency ablation of adrenal metastasis under enhanced CT guidance and general anesthesia. Chin J Interv Imaging Ther. 2018;15:521–525.

 Google Scholar

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.