Cure Alveolar Soft Part Sarcoma International (iCureASPS)

There are a few most significant factors influencing the rate of success in treatment of the lung mets using local ablation techniques, RFA and cryo:
1. The size (less then 20-30 mm is better)
2. The location (in the middle part of the lungs is better )
3. The experience of the interventional radiologist who is doing it (more then 100 cases is OK but more then 300 cases is better).
Speaking of the last one, I would not use the one that has done less then 100 applications as it directly influences the rate of the very serious complications (pneomothorax, bronchopleural fistula, needle track tumour dissemination) and the completeness of the ablation. The rate of the complications drops from 30-40 % for the beginners to less then 10 % for the experts.
There are a few experts in this field that are head and shoulders above the rest as they started years earlier and gained very significant experience by now.
In RFA:
Damian Dupuy, MD from Rhode Island Hospital http://biomed.brown.edu/facultydirector ... 1100924038
Robert D. Suh, MD from UCLA http://www.radnet.ucla.edu/radweb/resea ... ty/Suh.jsp

in Cryo:
Dr.Littrup, MD from Barbara Ann Karmanos Cancer Institute http://www.karmanos.org/PhysicianSearch ... me=littrup

This is the most comprehensive review on the subject that I found so far, it is written by Prof.Vogl who is one of the pillars of the ablative techniques standards and development committee, he is the head of the Institute for Diagnostic and Interventional Radiology in Frankfurt/Germany and is actually very accessible person - they provide an expert level ablative treatments for the international patients if needed in some complex cases, I have communicated with him before.

Radiofrequency, microwave and laser ablation of pulmonary neoplasms: Clinical studies and technical considerations-Review article.
Vogl TJ, Naguib NN, Lehnert T, Nour-Eldin NE.
Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
http://www.ncbi.nlm.nih.gov/pubmed/19700254

It is published in Science Direct but Ivan found it on the university web-site in PDF format to read here:
http://tinyurl.com/3866zat

Even reading the Article Outline gives one some idea re. subject ( Laser ablation and Microwave ablation are not in use in North Am. currently):
1. Introduction
2. Biological behavior and thermal physiology of the lung

2.1. Principle of hyperthermal ablation
2.2. Principle of cryoablation (hypothermal ablation)
2.3. Indications of pulmonary ablation therapy

3. Complications of pulmonary ablation therapy

3.1. Pneumothorax
3.2. Intraparenchymal hemorrhage
3.3. Pleural effusion
3.4. Tumor seeding
3.5. Unintentional thermal damage
3.6. Common minor side effects
3.7. Other rare complications

4. Radiofrequency ablation of pulmonary neoplasms

4.1. Basic principles of radiofrequency ablation and physical background
4.2. The monopolar and bipolar systems
4.3. RF generator, electrode design and energy delivery
4.4. Practical considerations and technical limitations of RF ablation of pulmonary neoplasms
4.5. Clinical studies using RF ablation technique

5. Microwave ablation

5.1. Physics of microwave heating
5.2. Microwave ablation compared to radiofrequency ablation
5.3. Clinical studies

6. Laser ablation

6.1. Basic principles of laser ablation and physical background
6.2. Laser ablation compared to RF ablation
6.3. Technique of LITT
6.4. Practical considerations and technical limitations of LITT therapy for treatment of lung neoplasms
6.5. Clinical studies

7. Conclusion

http://www.cureasps.org/forum/viewtopic.php?f=43&t=1082
In general cryoablation has less limitations than RFA or MW for close located vital structures as they return to normal working conditions after they de-freeze. Last Ivan's big cryo with Dr.Littrup was next to trachea and although it was longer in recovery and more cough, the cryoablation was done in the location RFA or MW could not be done. Radiosurgery could be done there and we were choosing between the two, but we choose cryo to preserve lungs, bones and heart.