A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: a novel therapy for multiple synchronous ground-glass opacities of the lung

Huang, Guanghui; Yang, Xia; Li, Wenhong; Wang, Jiao; Han, Xiaoying; Wei, Zhigang; Meng, Min; Ni, Yang; Zou, Zhigeng; Wen, Qiang; Dai, Jing; Zhang, Tiehong; Ye, Xin

doi:10.1080/02656736.2020.1756467

Cited by 37 publications

(30 citation statements)

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“…Given the unprecedented large lesions to be ablated and the combined utility of MWA with ITC in this study, ≥2 ablation antennae and ≥1 Chiba needles were used to cause multiple punctures through the pleura, which could slightly increase the incidence (52.3% vs. 31.9%) and severity (chest tube: 22.7% vs. 11.5%) of pneumothorax ( 7 ). Likewise, the incidence (77.3% vs. 68.2%) and severity (chest tube: 11.4% vs. 3.0%) of pleural effusion in this study were modestly higher than in our previous report, which was associated with severe thermal injury to the pleura due to a higher proportion (38.6%) of lesions involving the pleura or chest wall and a longer ablation time (mean 26.8 min) ( 6 ). The incidence (6.8%) of pulmonary infections, including bacterial (4.5%) and fungal (2.3%) infections corresponded with previously reported rates of 1%–6% ( 16 ).…”

Section: Discussioncontrasting

confidence: 70%

Synchronous Microwave Ablation Combined With Cisplatin Intratumoral Chemotherapy for Large Non-Small Cell Lung Cancer

Huang

Meng

et al. 2022

Front. Oncol.

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BackgroundMicrowave ablation (MWA) and intratumoral chemotherapy (ITC) are useful for treating tumors in animal models; however, their clinical use in patients with large non−small cell lung cancer (NSCLC) remains unknown. This retrospective study aimed to evaluate preliminary outcomes of MWA + ITC for large NSCLC.MethodsFrom November 2015 to April 2020, a total of 44 NSCLC patients with a mean lesion diameter of 6.1 ± 1.5 cm were enrolled and underwent synchronous MWA + ITC procedures. The primary endpoint was local progression-free survival (LPFS); secondary endpoints were progression-free survival (PFS), complications, overall survival (OS), and associated prognostic factors.ResultsThe median follow-up time was 19.0 months. At the 1-month CT scan, complete tumor ablation was observed in 47.7% of cases. Median LPFS was 12.1 months; 1-, 2-, and 3-year LPFS rates were 51.2%, 27.9%, and 13.6%, respectively. A shorter LPFS was significantly associated with large lesions (HR 1.23, 95% CI 1.02–1.49; p = 0.032). Median PFS was 8.1 months; 1-, 2-, and 3-year PFS rates were 29.5%, 18.2%, and 9.1%, respectively. LPFS was significantly superior to PFS (p = 0.046). Median OS was 18.8 months. The 1-, 2-, 3-, and 5-year OS rates were 65.9%, 43.2%, 26.4%, and 10.0%, respectively. In univariate comparisons, high performance status (PS) score, smoking, and larger lesions were significantly correlated with poor survival. In multivariate analysis, advanced age, higher PS score, higher stage, larger lesion, and prior systematic treatment were independent prognostic factors for shorter OS. Adverse events were well tolerated and all patients recovered after appropriate intervention.ConclusionsMWA + ITC is a safe and effective new modality of local treatment for large NSCLC and can significantly prolong LPFS.

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Section: Discussioncontrasting

confidence: 70%

Synchronous Microwave Ablation Combined With Cisplatin Intratumoral Chemotherapy for Large Non-Small Cell Lung Cancer

Huang

Meng

et al. 2022

Front. Oncol.

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“…Early evidence gleaned during the past few years suggests that pMWA may be a safe and feasible management strategy for patients with multiple GGOs. 30 Because the etiology of GGOs are so varied, combining with resection may provide a particular advantage in subsequent decision making regarding further completion surgery (eg, anatomical lung resection), medical therapy, or interval surveillance imaging. Similarly, thermal ablation is emerging as an alternative to stereotactic radiation therapy in the treatment of stage 1 non–small cell lung cancer suggesting that the application of iCART may expand to nonmetastatic pulmonary nodules in future.…”

Section: Discussionmentioning

confidence: 99%

Image-guided combined ablation and resection in thoracic surgery for the treatment of multiple pulmonary metastases: A preliminary case series

et al. 2021

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Objectives To demonstrate the feasibility and preliminary outcomes of a novel hybrid technique combining percutaneous microwave ablation and wire-assisted wedge resection for patients with multiple pulmonary metastases using intraoperative imaging. Methods We describe our technique and present a retrospective case series of 4 patients undergoing iCART at our institution between August 2018 and January 2020. Procedures were performed in a hybrid operating suite using the ARTIS Pheno cone beam computerized tomography scanner (Siemens Healthineers, Erlangen, German). Patient information included past history of malignancy as well as lesion size, depth, location, and histology result. Surgical complications and length of stay were also recorded. Results Five procedures were performed on 4 patients during the study period. One patient underwent bilateral procedures 4 weeks apart. All patients underwent at least 1 ablation and 1 wedge resection during the combined procedure. Patient ages ranged from 40 to 66 years and the majority (75%) were men. All had a past history of cancer. Lesions were treated in every lobe. Size and depth ranged from 6 to 24 mm and 21 to 33 mm, respectively, for ablated nodules and 5 to 27 mm and 0 to 22 mm, respectively, for the wedge resected nodules. Three procedures were completed uniportal and operative time ranged from 51 to 210 minutes. All cases sustained <10 mL blood loss. There were 2 intraoperative pneumothorax, 1 prevented successful completion of the ablation. One patient required a prolonged period of postoperative physiotherapy and was discharged on day 6. The other patients were discharged on postoperative day 2 or 3. All 5 histology specimens confirmed metastatic disease. Conclusions Our hybrid approach provides a minimally invasive and comprehensive personalized therapy for patients with multiple pulmonary metastases under a single general anesthetic. It provides histology-based diagnosis whilst minimizing lung tissue loss and eliminating the need for transfer from radiology to operating theatre. Emergence of ablation as a treatment for stage 1 non–small cell lung cancer and the expansion of lung cancer screening may widen the application of iCART in the future.

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“…Image-guided percutaneous thermal ablation, including radiofrequency ablation, microwave ablation (MWA), and cryoablation, has been increasingly used for medically inoperable patients with early-stage lung cancer [ 62 , 63 ]. Recently, these techniques have also been applied in the management of MPLC with promising results [ 64 , 65 ]. Huang et al reported a 100% technical success rate of treating multiple synchronous GGOs with computed-tomography–guided percutaneous MWA, with an acceptable complication rate [ 65 ].…”

Section: Management Of Mplcmentioning

confidence: 99%

“…Recently, these techniques have also been applied in the management of MPLC with promising results [ 64 , 65 ]. Huang et al reported a 100% technical success rate of treating multiple synchronous GGOs with computed-tomography–guided percutaneous MWA, with an acceptable complication rate [ 65 ]. Qu et al further combined electromagnetic navigation bronchoscopy (ENB)-guided MWA with uniportal VATS in 11 patients with multiple GGO, and reported a 100% success rate, with no recurrence observed at follow-up [ 66 ].…”

Section: Management Of Mplcmentioning

confidence: 99%

Recent Advances in the Diagnosis and Management of Multiple Primary Lung Cancer

Chiang

Tsai

Yeh

et al. 2022

Cancers

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With the wide application of computed tomography in lung cancer screening, the incidence of multiple primary lung cancer (MPLC) has been increasingly reported. Despite the established criteria, the differentiation between MPLC and intrapulmonary metastasis remains challenging. Although histologic features are helpful in some circumstances, a molecular analysis is often needed. The application of next-generation sequencing could aid in distinguishing MPLCs from intrapulmonary metastasis, decreasing ambiguity. For MPLC management, surgery with lobectomy is the main operation method. Limited resection does not appear to negatively affect survival, and it is a reasonable alternative. Stereotactic ablative radiotherapy (SABR) has become a standard of care for patients refusing surgery or for those with medically inoperable early-stage lung cancer. However, the efficacy of SABR in MPLC management could only be found in retrospective series. Other local ablation techniques are an emerging alternative for the control of residual lesions. Furthermore, systemic therapies, such as targeted therapy for oncogene-addicted patients, and immunotherapy have shown promising results in MPLC management after resection. In this paper, the recent advances in the diagnosis and management of MPLC are reviewed.

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A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: a novel therapy for multiple synchronous ground-glass opacities of the lung

Abstract: Ye (2020) A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: a novel therapy for multiple synchronous ground-glass opacities of the lung, International

Cited by 37 publications

References 41 publications

Synchronous Microwave Ablation Combined With Cisplatin Intratumoral Chemotherapy for Large Non-Small Cell Lung Cancer

Synchronous Microwave Ablation Combined With Cisplatin Intratumoral Chemotherapy for Large Non-Small Cell Lung Cancer

Image-guided combined ablation and resection in thoracic surgery for the treatment of multiple pulmonary metastases: A preliminary case series

Recent Advances in the Diagnosis and Management of Multiple Primary Lung Cancer

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