Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer

Abstract

Introduction: This study aimed to evaluate the long-term outcome of microwave ablation (MWA) of early-stage non-small cell lung cancer (NSCLC), including response to treatment and survival. Methods: This retrospective study was conducted on consecutive patients who underwent computed tomography-guided MWA of early-stage NSCLC (no evidence of nodal or distant metastasis) from November 2010 to December 2014 at our institution. Data were collected from systematic review of patient charts and imaging. Procedural complications, response to treatment and survival were assessed. Results: 34 early-stage (T1a-T3N0M0) NSCLCs in 30 patients were treated with a total of 41 MWA sessions. There were no intraprocedural or 30-day post-procedural deaths. The most common complication was pneumothorax, encountered in 24 (59%) microwave ablation sessions, six (15%) of which required chest tube insertion. Over a median computed tomography follow-up period of 39 months (range 3-89), 24 (71%) NSCLCs demonstrated local control, while 10 (29%) demonstrated local progression. Nodal/distant progression was more common than local progression, with 15 of the 30 patients (50%) having nodal or distant metastases at follow-up. Patient survival status was followed up over a median period of 56.5 months (range 10-107). Median overall survival and 5-year overall survival were 56.5 months (95% confidence interval, 26-not reached) and 46.7% (95% confidence interval, 31.8-68.4), respectively. Conclusion: MWA is safe and effective at achieving local control of early-stage NSCLC and may prolong patient survival. Nodal or distant metastases were the dominant manifestations of disease progression at long-term follow-up.

Massive lung necrosis due to microwave ablation in an octogenarian required urgent lobectomy

“…6 Henry Zhao and Steinke reported that in 30 patients with a median follow-up period of 56.5 months, nodal/distant progression was more common than local progression, (50% having nodal or distant metastases at follow-up vs 29% of local progression). 9 This reinforces the benefit of systemic lymphatic resection in the curative surgical treatment of NSCLC, even in the early stages. In elderly patients aged 80 years and older, Han et al reported 63 patients with a median survival time 50 months with 5-year overall survival rates of 32.6%; 22.2% had local progression.…”

“…The local progression rates after MWA of lung malignancies vary between 0% and 34% 6. Henry Zhao and Steinke reported that in 30 patients with a median follow-up period of 56.5 months, nodal/distant progression was more common than local progression, (50% having nodal or distant metastases at follow-up vs 29% of local progression) 9. This reinforces the benefit of systemic lymphatic resection in the curative surgical treatment of NSCLC, even in the early stages.…”

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

“…MWA is increasingly used for radical treatment of inoperable early-stage NSCLC or refusal of surgery and has comparable therapeutic effects to SBRT ( 18 ). Generally, most patients are clearly defined as stage I with lesions ≤4 cm, while the remaining few cases were stage T2b-3N0M0 with lesions > 4 cm ( 7 , 19 , 20 ). In this study, the lesions of seven patients at stages IIA and IIB were confined to the lungs and could not be surgically removed due to chronic comorbidities.…”

Safety and utility of performing CT‐guided biopsies of pulmonary lesions that arise after radiotherapy

“…Percutaneous ablation therapy is an important treatment option for lung malignancy developing after radiation therapy. 23,24 Repeat stereotactic radiotherapy has also been reported to be useful recently. 8 The difficulty in differentiating lesions after radiotherapy can be an issue in these treatments.…”