Safety and efficacy of microwave ablation for lung cancer adjacent to the interlobar fissure

Abstract

Background This retrospective study aimed to assess the safety and efficacy of microwave ablation for lung tumors adjacent to the interlobar fissures. Methods From May 2020 to April 2021, 59 patients with 66 lung tumors (mean diameter, 16.9 ± 7.7 mm; range, 6–30 mm) adjacent to the interlobar fissures who underwent microwave ablation at our institution were identified and included in this study. Based on the relationship between the tumor and the interlobar fissure, tumors can be categorized into close to the fissure, causing the fissure, and involving the fissure. The complete ablation rate, local progression‐free survival, complications, and associated factors were analyzed. Results All 66 histologically proven tumors were treated using computed tomography‐guided microwave ablation. The complete ablation rate was 95.5%. Local progression‐free survival at 3, 6, 9, and 12 months were 89.4%, 83.3%, 74.2%, and 63.6%, respectively. The complications included pneumothorax (34.8%), pleural effusion (24.2%), cavity (18.2%), and pulmonary infection (7.6%). There were statistical differences in the incidence of pneumothorax, cavity, and delayed complications between the groups with and without antenna punctures through the fissure. Conclusions Microwave ablation is a safe and effective treatment for lung tumor adjacent to the interlobar fissure. Antenna puncturing though the interlobar fissure may be a potential risk factor for pneumothorax, cavity, and delayed complications.

Emergency Surgical Intervention in Microwave Ablation-Induced Massive Lung Necrosis

“…Furthermore, in a study assessing the safety of MWA procedures adjacent to the interlobar fissure, the overall success rate for ablation was 95.5%, and the PFS rates at 3, 6, 9, and 12 months were 89.4%, 83.3%, 74.2%, and 63.6%, respectively [ 4 ]. Common complications observed included pneumothorax (34.8%), pleural effusion (24.2%), cavity formation (18.2%), and pulmonary infection (7.6%) [ 4 ]. Other complications of MWA include pulmonary hemorrhage, chest wall injury, pulmonary abscess, thermal injury to adjacent structures, and tumor recurrence [ 1 ].…”

“…Other complications of MWA include pulmonary hemorrhage, chest wall injury, pulmonary abscess, thermal injury to adjacent structures, and tumor recurrence [ 1 ]. It was suggested that puncturing the antenna through the interlobar fissure might pose a potential risk for complications [ 4 ].…”

Treatment strategies for malignant pulmonary nodule: beyond lobectomy. Point-counterpoint

“…All the above cohorts demonstrated an excellent safety profile of BMWA with a lower rate of pleuralbased complication than percutaneous ablation, although future prospective studies are needed to confirm this. Subpleural or lesions close to the pleura poses additional risks relating to pleuralbased complications [87]. Our experience has shown that in around 66.7% of BMWA cases the ablation zone reached the pleura, and yet, the rate of pneumothorax was only for subpleural lung nodules [89].…”

Advances in Antenna-Based Techniques for Detection and Monitoring of Critical Chronic Diseases: A Comprehensive Review

“…Lung tumors may be close to vital organs, demanding precise targeting to avoid harming healthy tissues [80] Implement Focused Antenna Design and Beamforming: Design antennas with focused radiation patterns and employ beamforming techniques to concentrate energy on the tumor while minimizing exposure to surrounding healthy tissues [80], [81].…”