CT-guided percutaneous microwave ablation of pulmonary malignancies: Results in 69 cases

Abstract

BackgroundMicrowave ablation (MWA) has attracted a worldwide attention gradually in treating inoperable pulmonary malignancies. However, in the lung tissues treated with MWA recurrence of tumor may still occur and few data in large patient groups till now were reported about the safety or effectiveness of microwave ablation in treating primary lung cancer and metastatic pulmonary malignancies. The purpose of this study is to evaluate the clinical curative effect (local control, survival data) MWA and its safety as well.MethodsFrom 1 January 2005 to 1 January 2008, retrospective analyses, 69 patients underwent computed tomography (CT)-guided percutaneous MWA of pulmonary malignancies. All patients were deemed medically inoperable. The correlation of tumor sizes and local progression after ablation was analyzed and the survival rates within 3 years post surgery were compared between non-small-cell lung cancer and pulmonary metastases groups also.ResultsPneumothorax was the most frequent complication and occurred in 24.64% patients after ablation. Neither needle track implantation was found nor did patient death occur in these patients within 30 days. The 1-, 2-, and 3-year overall survival rates were 66.7%, 44.9% and 24.6%, respectively. The overall survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 75.0%, 54.2%, and 29.2%, respectively. The overall survival rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 23.8%, and 14.3%, respectively. The recurrence-free survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 72.9%, 50.0%, and 27.1%, respectively. The mortality rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 19.0%, and 14.3%, respectively.ConclusionsPercutaneous microwave coagulation therapy was one safe and effective method and could be beneficial for the improvement of inoperable pulmonary malignancies treatment effect.

Lung radiofrequency and microwave ablation: a review of indications, techniques and post-procedural imaging appearances

“…Much of the available literature is based upon outcomes after RFA, but there is a growing body of evidence to support MA. [4][5][6][7] Microwave does have certain theoretical advantages in that ablation times are typically much shorter (2-5 min, as opposed to 12-15 min for a similar-sized treatment area). Energy propagates directly through air and tissue, and the high intrinsic impedance of lung tissue is therefore not a barrier to effective treatment.…”

Thermal Ablation of Malignant Lung Tumors

“…Clinical experience following microwave ablation is very limited; only a few case series have been published to date (29)(30)(31)(32). As for RFA, no randomized trials are yet available.…”

Thermal Ablation of Lung Tumors: Focus on Microwave Ablation

“…The 1-and 2-year OS rates were 91.3 % and 75 %, respectively [2]. Lu et al reported much worse 1-, 2-, and 3-year OS rates after the ablation of 37 lung metastases: 47.6 %, 23.8 %, and 14.3 %, respectively [3]. Finally, Egashira et al reported an LTP of only 2.3 % after the ablation of 87 lung metastases with a median follow-up of 15 months [22].…”

“…Pain can be encountered after 2 -27.6 % of MWA ablations (▶ Table 1) [1,3,8,12]. Generally, the severity is mild to moderate, and it persists for a few days to a few weeks.…”

“…An intrapulmonary hemorrhage appears as a rapidly expanding GGO starting from the antenna and can be associated with hemoptysis. Intraparenchymal hemorrhages occur in 6 -10 % of MWAs and lead to hemoptysis in 0 -7 % of cases [2,3,16,22]. Yang et al reported a hemoptysis rate as high as 36 % [12].…”