Long-term outcome following microwave ablation of early-stage non-small cell lung cancer

Lung Cancer
28/07/2020

J Med Imaging Radiat Oncol. 2020 Jul 28. doi: 10.1111/1754-9485.13091. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the long-term outcome of microwave ablation (MWA) of early-stage non-small cell lung cancer (NSCLC), including response to treatment and survival.

METHODS: This retrospective study was conducted on consecutive patients who underwent computed tomography-guided MWA of early-stage NSCLC (no evidence of nodal or distant metastasis) from November 2010 to December 2014 at our institution. Data were collected from systematic review of patient charts and imaging. Procedural complications, response to treatment and survival were assessed.

RESULTS: 34 early-stage (T1a-T3N0M0) NSCLCs in 30 patients were treated with a total of 41 MWA sessions. There were no intraprocedural or 30-day post-procedural deaths. The most common complication was pneumothorax, encountered in 24 (59%) microwave ablation sessions, six (15%) of which required chest tube insertion. Over a median computed tomography follow-up period of 39 months (range 3-89), 24 (71%) NSCLCs demonstrated local control, while 10 (29%) demonstrated local progression. Nodal/distant progression was more common than local progression, with 15 of the 30 patients (50%) having nodal or distant metastases at follow-up. Patient survival status was followed up over a median period of 56.5 months (range 10-107). Median overall survival and 5-year overall survival were 56.5 months (95% confidence interval, 26-not reached) and 46.7% (95% confidence interval, 31.8-68.4), respectively.

CONCLUSION: MWA is safe and effective at achieving local control of early-stage NSCLC and may prolong patient survival. Nodal or distant metastases were the dominant manifestations of disease progression at long-term follow-up.