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Published on: March 3, 2023
Outcomes following microwave ablation of 669 primary and metastatic lung malignancies
Ruben Geevarghese1, Erica S Alexander1, Ahmed Elsakka1
1Division of Interventional Radiology, Department of Radiology, Room H118, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Objectives:
Percutaneous ablation is a treatment modality used in the management of primary and metastatic lung malignancies. Factors affecting local control rate (LCR) following microwave ablation (MWA) are poorly understood due to inconsistent and limited reporting of histology and procedure-related outcomes.
Materials And Methods:
Single-center retrospective study of patients with primary and metastatic lung malignancies who underwent MWA between January 2010 and July 2021. Patient, tumor and ablation characteristics were recorded. Outcomes evaluated included technical success, local tumor control and adverse events (AEs).
Results:
A total of 669 nodules were identified from 383 patients (197 male/186 female with a median age of 59 years (IQR = 21 years)) across 459 ablation sessions. This comprised 83 primary and 586 metastatic lung tumors. One-year and two-year local LCRs (±SD) across the cohort were 90.3% (±1.1%) and 84.7% (±1.4%), respectively. Multivariable analysis identified ablation power settings, age, concomitant chemotherapy and histology as significant covariates associated with time to local recurrence (TTLR). Standard power was associated with longer TTLR, compared to low power, with no significant difference in AE rates. A significant difference in TTLR was noted between different histological groups.
Conclusion:
MWA of primary and metastatic lung tumors is safe and effective. LCRs differ across different histologies. Standard power MWA is associated with longer TTLR without increased AEs rates.
Key Points:
Question Reported local control rates for microwave ablation (MWA) vary widely, with limited and heterogeneous data on histology-specific and parameter-related outcomes, leaving a gap in understanding. Findings MWA achieved 90.3% and 84.7% one- and two-year local control rates, with longer time to recurrence for standard power MWA. Histology-specific differences noted in time to recurrence. Clinical relevance MWA is a safe and effective treatment for primary and secondary lung cancers, offering comparable local control rates to radiotherapy and surgical resection. Further refinement of treatment parameters may enhance outcomes and address histology-specific challenges.
