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Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Microwave Ablation of Refractory Oligometastatic Non-Small Cell Lung Cancer in the Liver
Ruben Geevarghese1, Henry Kunin1, Elena N Petre1
1Division of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Purpose:
To evaluate safety and effectiveness of microwave ablation (MWA) in the treatment of liver metastases (LMs) secondary to non-small cell lung cancer (NSCLC).
Materials And Methods:
This retrospective study included patients with NSCLC who underwent MWA of LM from March 2015 to July 2022. Local tumor progression-free survival (LTPFS) and overall survival (OS) were estimated using competing risk analysis and the Kaplan-Meier method. Postprocedural adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Results:
Twenty-three patients with 32 LMs were treated in 27 MWA sessions. The mean dimension of the largest index tumor was 1.96 cm (SD ± 0.75). Technical success was 100%. Technical effectiveness was achieved in 26 (81.3%) of 32 tumors. The median length of follow-up was 37.7 months (interquartile range, 20.5-54.5 months). The median LTPFS was 16.3 months (95% confidence interval [CI], 7.87-44.10 months). The median OS was 31.7 months (95% CI, 11.1-65.8 months). Ablation margin was a significant factor for LTPFS, with tumors ablated without a measurable margin being more likely to progress than those with measurable margins (subdistribution hazard ratios [HRs], 0.008-0.024; P < .001). Older age (HR, 1.18; 95% CI, 1.09-1.28; P < .001) and presence of synchronous lung metastases (HR, 14.73; 95% CI, 1.86-116.95; P = .011) were significant predictors of OS. Serious adverse events (CTCAE Grade ≥3) within 30 days occurred in 2 (7.4%) of 27 sessions, including pulmonary embolus and severe abdominal pain.
Conclusions:
Percutaneous MWA was a safe treatment for NSCLC LM, with longer survival noted in younger patients and those without synchronous lung tumors.
Insights
Microwave ablation (MWA) is a safe and effective treatment for liver metastases (LMs) from non-small cell lung cancer (NSCLC). Younger patients and those without synchronous lung tumors showed longer survival.
Area of Science:
- Oncology
- Interventional Radiology
Background:
- Liver metastases (LMs) are common in non-small cell lung cancer (NSCLC).
- Microwave ablation (MWA) offers a minimally invasive treatment option for LMs.
Purpose of the Study:
- To evaluate the safety and effectiveness of MWA for treating LMs in NSCLC patients.
- To identify factors influencing local tumor progression-free survival (LTPFS) and overall survival (OS).
Main Methods:
- Retrospective analysis of 23 NSCLC patients with 32 LMs treated with MWA (March 2015-July 2022).
- Kaplan-Meier and competing risk analyses for LTPFS and OS.
- Adverse events recorded per CTCAE v5.0.
Main Results:
- 100% technical success and 81.3% technical effectiveness for 32 LMs.
- Median LTPFS of 16.3 months and median OS of 31.7 months.
- Ablation margin, older age, and synchronous lung metastases significantly impacted survival.
Conclusions:
- Percutaneous MWA is a safe and effective treatment for NSCLC-related LMs.
- Favorable survival outcomes observed in younger patients and those without synchronous lung tumors.
