The safety and efficacy of microwave ablation for the treatment of CRC pulmonary metastases

Gang, Cheng; Shi, Liangrong; Qiang, Weiguang; Wu, Jun; Ji, Mei; Lu, Qicheng; Li, Xiaodong; Xu, Bin; Jiang, Jingting; Wu, Changping

doi:10.1080/02656736.2017.1366553

Cited by 18 publications

(17 citation statements)

References 39 publications

(51 reference statements)

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“…61 Among previous investigations, tumor size has remained a fairly consistent limiting factor for the widespread use of ablation, regardless of type of energy used. 52 Prior authors have shown that the most favorable local tumor control has been due to a small tumor size 63 and the creation of 5 mm minimal ablation margin, which is considered a minimum requirement for pulmonary ablation. 48,51,61 In a review by de Baere and colleagues, 48 again, it was shown that poorer outcomes from radiofrequency ablation (RFA) were seen with size greater than 2 cm (HR, 2.10; P ¼ .0027); not surprisingly, similar to findings from other modalities (such as surgery), greater number of metastases (3 nodules, HR, 1.86, P ¼ .011) and shorter DFI were also associated with worse oncologic outcomes.…”

Section: Role Of Transthoracic Ablation For Pulmonary Metastasesmentioning

confidence: 99%

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Antonoff

Sofocleous

Callstrom

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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Section: Role Of Transthoracic Ablation For Pulmonary Metastasesmentioning

confidence: 99%

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Antonoff

Sofocleous

Callstrom

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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“…A systemic review reported that the incidence rate of pneumothorax after RFA ranged between 1.3% and 60% [11]. Although MWA requires fewer ablation needles and has a lesser ablation duration, the occurrence of pneumothorax after MWA appears to be unchanged, with a reported incidence rate of 21.1-63% [2,12]. In addition, Yoshimatsu et al [13] reported an incidence rate of 10.3% for delayed pneumothorax after RFA.…”

Section: Introductionmentioning

confidence: 99%

Risk prediction of pneumothorax in lung malignancy patients treated with percutaneous microwave ablation: development of nomogram model

et al. 2021

International Journal of Hyperthermia

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Objectives: To develop effective nomograms for predicting pneumothorax and delayed pneumothorax after microwave ablation (MWA) in lung malignancy (LM) patients. Methods: LM patients treated with MWA were randomly allocated to a training or validation cohort at a ratio of 7:3. The predictors of pneumothorax identified by univariate and multivariate analyses in the training cohort were used to develop a predictive nomogram. The C-statistic was used to evaluate predictive accuracy in both cohorts. A second nomogram for predicting delayed pneumothorax was developed and validated using identical methods. Results: A total of 552 patients (training cohort: n ¼ 402; validation cohort: n ¼ 150) were included; of these patients, 27.9% (154/552) developed pneumothorax, with immediate and delayed pneumothorax occurring in 18.8% (104/552) and 9.1% (50/552), respectively. The predictors selected for the nomogram of pneumothorax were emphysema (hazard ratio [HR], 6.543; p < .001), history of lung ablation (HR, 7.841; p¼ .025), number of pleural punctures (HR, 1.416; p < .050), ablation zone encompassing pleura (HR, 10.225; p < .001) and pulmonary fissure traversed by needle (HR, 10.776; p < .001). The Cstatistics showed good predictive performance in the training and validation cohorts (0.792 and 0.832, respectively). Another nomogram for delayed pneumothorax was developed based on emphysema (HR, 2.952; p¼ .005), ablation zone encompassing pleura (HR, 4.915; p < .001) and pulmonary fissure traversed by needle (HR, 4.348; p ¼ .015). The C-statistics showed good predictive performance in the training cohort, and it had efficacy for prediction in the validation cohort (0.719 and 0.689, respectively). Conclusions: The nomograms could effectively predict the risk of pneumothorax and delayed pneumothorax after MWA.

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“…Table 2 shows the outcomes of ablative therapies for lung metastases from CRC [12,[18][19][20][21][22][23][24][25][26][27][28][29][30][31]. RFA was the most frequently used treatment in the listed studies.…”

Section: Colorectal Cancermentioning

confidence: 99%

“…In a study on RFA for lung metastases from various primary tumors, de Baère et al performed subgroup analyses for each group of patients with colon and rectal cancer and reported 5-year OS rates of 56.0% and 49.6% in the colon and rectum groups, respectively [12]. In the other studies, the 3-and 5-year OS rates after ablative therapies for lung metastases from CRC were 44-61% and 20-30%, respectively [21,22,24,26,[28][29][30][31]. Local tumor control rates by ablative therapies were approximately 80-90% in most studies; notably, several studies published from 2018 onward achieved local control rates of 90% or higher [18,19,21,23].…”

Section: Colorectal Cancermentioning

confidence: 99%

Up-to-date evidence on image-guided thermal ablation for metastatic lung tumors: a review

et al. 2022

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The aim of this review was to summarize the latest evidence on image-guided thermal ablation therapies for lung metastases. PubMed was used to search for relevant articles that reported the oncological outcomes of thermal ablation for metastatic lung tumors, and those published in 2010 or later were selected for review. Ablative therapies were applied for lung metastases from various types of primary tumors, but most commonly colorectal ones. Radiofrequency ablation (RFA) was the most evaluated technique, followed by microwave ablation (MWA). The local control rates of ablative therapies were generally favorable, approximately 80–90% in many studies. Representative studies demonstrated promising overall survival rates of approximately 50% or higher 5 years after ablation for lung metastases from colorectal cancer or mixed types of primary tumors. Nevertheless, the survival outcomes varied depending on the type of primary tumor and background factors of patients such as other metastases and comorbidities. Several studies had aimed to compare the outcomes of various ablative therapies such as RFA, MWA, and cryoablation; however, conclusive data are not yet available to determine the most appropriate ablation modality for lung metastases. Further data accumulation is needed, especially for long-term outcomes and comparisons with other therapies.

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The safety and efficacy of microwave ablation for the treatment of CRC pulmonary metastases

Abstract: CT-guided percutaneous MWA is a safe and effective minimally invasive method for treating CRC pulmonary metastases.

Cited by 18 publications

References 39 publications

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Risk prediction of pneumothorax in lung malignancy patients treated with percutaneous microwave ablation: development of nomogram model

Up-to-date evidence on image-guided thermal ablation for metastatic lung tumors: a review

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