Local Efficacy and Survival after Microwave Ablation of Lung Tumors: A Retrospective Study in 183 Patients

J Vasc Interv Radiol. 2016 Dec;27(12):1806-1814. doi: 10.1016/j.jvir.2016.08.013. Epub 2016 Oct 24.

Abstract

Purpose: To retrospectively evaluate local efficacy and survival after microwave (MW) ablation of lung tumors and identify predictors of prognosis.

Materials and methods: Data from 183 consecutive patients (67 women; mean age, 61.5 y ± 13.4) with lung tumors who had undergone 203 lung MW ablation sessions from January 2011 to May 2013 were assessed. The χ2 test, independent-samples t test, Kaplan-Meier analysis, and Cox regression model analysis were used to estimate survival rates and evaluate significance of factors affecting rates of incomplete ablation, local progression, remote progression-free survival (RPFS), and cancer-specific survival (CSS).

Results: Technical success rate was 100%. Incomplete ablation rate after 183 first MW ablations was 14.2% (26 of 183); maximum diameter of target tumors (P = .00001) was associated with incomplete ablation on univariate analysis. The local progression rate was 19.1% (35 of 183); emphysema (P = .020) and maximum diameter of target tumor (P = .000003) were associated with local progression. Median and 4-year RPFS were 15.0 months (95% confidence interval [CI], 11.1-18.9 mo) and 23.8%, respectively. Tumor stage (P < .01) and incomplete ablation (P = .002) were independent predictors of RPFS. Median and 4-year CSS were 24.9 months (95% CI, 19.9-29.9 mo) and 31.1%, respectively. Median and 4-year overall survival were 23.7 months (95% CI, 20.6-26.8 mo) and 29.6%, respectively. Tumor stage (P < .01) and maximum diameter (P = .009) were independent risk factors for CSS.

Conclusions: MW ablation is effective for lung tumors, especially small lesions of early-stage primary lung cancer and solitary lung metastasis.

MeSH terms

  • Ablation Techniques / adverse effects
  • Aged
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Microwaves / adverse effects
  • Microwaves / therapeutic use*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Burden