Microwave Ablation for Lung Neoplasms: A Retrospective Analysis of Long-Term Results

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• 作者：Terrance T. Healey ; MD ; Bradford T. March ; MD ; Grayson Baird ; MS ; Damian E. Dupuy ; MD ; ^{ddupuy@lifespan.org}
• 关键词：BPF ; bronchopleural fistula ; CI ; confidence interval ; FDG ; [18F]fluorodeoxyglucose ; MW ; microwave ; OMD ; original tumor maximal diameter ; RF ; radiofrequency ; RT ; radiation therapy
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：28
• 期：2
• 页码：206-211
• 全文大小：427 K
• 卷排序：28

文摘

To determine the long-term safety and efficacy of microwave (MW) ablation in the treatment of lung tumors at a single academic medical center.Materials and MethodsRetrospective review was performed of 108 patients (42 female; mean age, 72.5 y ± 10.3 [standard deviation]) who underwent computed tomography (CT)–guided percutaneous MW ablation for a single lung malignancy. Eighty-two were primary non–small-cell lung cancers and 24 were metastatic tumors (9 colorectal carcinoma, 2 renal-cell carcinoma, 4 sarcoma, 2 lung, and 7 other). Mean maximum tumor diameter was 29.6 mm ± 17.2. Patient clinical and imaging data were reviewed. Statistical analysis was performed by Kaplan–Meier modeling and logistic regression.ResultsOdds of primary technical success were 11.1 times higher for tumors < 3 cm vs those > 3 cm (95% confidence interval [CI], 2.97–41.1; P = .0003). For every millimeter increase in original tumor maximal diameter (OMD), the odds of not attaining success increased by 7% (95% CI, 3%–10%; P = .0002). For every millimeter increase in OMD, the odds of complications increased by 3% (95% CI, 0.1%–5%; P = .04). Median time to tumor recurrence was 62 months (95% CI, 29, upper bound not reached; range, 0.2–96.6 mo). Recurrence rates were estimated at 22%, 36%, and 44% at 1, 2, and 3 years, respectively. Recurrence rates were estimated at 31% at 13 months for tumors > 3 cm and 17% for those < 3 cm. Complications included pneumothorax (32%), unplanned hospital admission (28%), pain (20%), infection (7%), and postablation syndrome (4%).ConclusionsThis study further supports the safe and effective use of MW ablation for the treatment of lung tumors.