CT-guided microwave ablation for large inoperable pulmonary metastases from sarcoma: a case series

This study aimed to retrospectively evaluate the feasibility, efficacy and safety of percutaneous computed tomography (CT)-guided microwave ablation (MWA) for the treatment of large inoperable pulmonary metastases from sarcoma.

The study was approved by the institutional review board, and informed consent was obtained from all patients. From January 1, 2011, to May 1, 2018, 15 patients with sarcoma (9 males and 6 females; median age 35 years) with 17 large inoperable pulmonary metastases from sarcoma (mean size, 7.6 ± 1.7 cm; range, 5.0-10.8 cm) received percutaneous CT-guided microwave ablation. The treatment efficacy, complications and overall survival were evaluated.

The median follow-up was 24.6 months (range 1.6-65.8 months). Complete response was achieved in 4 tumors (23.5%), partial response in 11 tumors (64.7%), while 2 tumors (11.8%) demonstrated disease progression. The 1-, 2- and 3-year overall survival rates were 78.6%, 69.8% and 50.9%, respectively. The median overall survival time was 39 months (95% CI 18.2-59.8 months). Curative ablation was associated with significantly improved local progression-free survival compared with palliative ablation (median LPFS: not reached vs 17.09 months; HR 4.913, 95% CI: 1.039-23.24, P = .046). No treatment-related death occurred. Pneumothorax was the most common complication with an incidence of 20.8%(n = 5). The median hospital stay was 5 days.

CT-guided microwave ablation appears to be a safe and effective treatment for large inoperable pulmonary metastases from sarcoma.

CT-guided MWA can be used as an alternative treatment for patients with large inoperable lung metastases from sarcoma with potential clinical benefits.