Patient survival in lung malignancies treated by microwave ablation

http://www.ncbi.nlm.nih.gov/pubmed/23099201

Eur J Radiol. 2012 Oct 22. pii: S0720-048X(12)00459-7. doi: 10.1016/j.ejrad.2012.08.024. [Epub ahead of print]

Patients' survival in lung malignancies treated by microwave ablation: our experience on 56 patients.

Belfiore G, Ronza F, Belfiore MP, Serao N, di Ronza G, Grassi R, Rotondo A.

Source

Department of Diagnostic Imaging, "S. Anna-S. Sebastiano" Hospital, Via F. Palasciano, 81100 Caserta, Italy.

Abstract

OBJECTIVES:

We retrospectively evaluated percutaneous CT-guided microwave (MW) ablation safety and efficacy in unresectable lung malignancies focusing on patients' survival.

MATERIALS AND METHODS:

All procedures were approved by the hospital ethical committee. From 2008 to 2012 we treated 69 unresectable lesions (44 lung cancer, 25 lung metastases) in 56 patients (35 men/21 women; mean age: 61.5years). Treatment was performed under CT guidance using 14G needles with a 3cm active tip and a 55W MW generator (Vivawave Microwave Coagulation System; Valley Lab). Treatment was performed at 45W for 6-10min. Patients were scheduled for a 3 and 6month CT follow-up to evaluate lesion diameter and enhancement. Survival rate was evaluated by Kaplan-Meier analysis.

RESULTS:

Ablation procedures were completed according to protocol in all patients. Pneumothorax occurred in 18 patients and 8 required chest tube. Four lesions (all >4.3cm) were retreated 20days after the ablation because of peripheral focal areas of residual tumor. Follow-up CT evaluation showed a decrease in maximum diameter in 44/69 lesions (64%) and in 42/59 lesions (71%) at 3 and 6months, respectively. In all cases no pathologic enhancement was observed. Cancer-specific mortality yielded a survival rate of 69% at 12months, 54% at 24months and 49% at 36months, respectively. An estimate mean for survival time was 27.8months with a standard error of 2.8months (95% confidence interval: 22.4-33.2months).

CONCLUSION:

Based on our experience, MW ablation seems to represent a potential safe and effective percutaneous technique in the treatment oflung malignancies. MW ablation may improve survival in patients not suitable to surgery.