Cryoablation Protocols for Primary and Metastatic Lung Tumors: A Systematic Review and Meta-analysis Evaluating Effectiveness and Safety of Percutaneous Cryoablation of Pulmonary Tumors

PURPOSE: This systematic review and meta-analysis aimed to evaluate 1-year local tumor control (LTC) after percutaneous cryoablation for lung tumors, and to identify procedural protocol and patient/tumor characteristics associated with improved outcomes. METHODS: A systematic search of PubMed, EMBASE and Web of Science was conducted. The primary outcome was LTC at 1 year. Secondary outcomes included the identification of factors associated with LTC and pooled adverse event rates, such as freezing lengths, number of cycles, tumor characteristics, and more. Data were pooled using a random-effects model, and meta-regression was used to analyze factors affecting LTC. RESULTS: Nineteen studies (786 patients, 1048 tumors) yielded a pooled 1-year LTC of 90.5% (95% CI, 85.1%-94.1%). Multivariable meta-regression showed that smaller tumor size was significantly associated with improved LTC. Univariable analysis also identified that superior LTC was associated with a triple freeze-thaw protocols (vs. double), a shorter first freeze duration, a longer final freeze duration, and ending the procedure with a thaw cycle. The incidence of adverse events (CTCAE Grade

• Sarshoghi, A.
• Sarshoghi, A.
• Tetu, M.
• Ng, C. S. H.
• Yarmus, L.
• Bourgouin, P.
• Solomon, S. B.
• Herth, F.
• Liddell, R. P.
• Liberman, M.