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探索不同功率输出对肺癌微波消融疗效和安全性的影响:一项真实世界研究

Exploring the impact of variable power outputs on the efficacy and safety during microwave ablation for lung carcinoma: a real-world study.

作者信息

Cui Song-Ping, Zhao Qing, Wang Jing, Ji Ying, Miao Jin-Bai, Fu Yi-Li, Hu Bin, Chen Shuo

机构信息

Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Mass General Cancer Center, Mass General Brigham, Harvard Medical School, Boston, MA, USA.

出版信息

J Thorac Dis. 2024 Aug 31;16(8):5031-5041. doi: 10.21037/jtd-24-557. Epub 2024 Aug 28.

Abstract

BACKGROUND

Microwave ablation (MWA) is an important method for the treatment of lung cancer, but there is still a lack of standard guidelines for the selection of power. This study aimed to explore the effectiveness and safety of MWA at different power levels.

METHODS

The study gathered individuals underwent MWA for lung cancer between January 2012 and December 2020. All patients were divided into low power group and high power group based on the power of MWA. By intergroup comparisons, we clarified the differences between the two groups.

RESULTS

In this study, 265 participants were involved, with 192 in the low power group and 73 in the high power group. Compared to the low power group, the high power group had a significantly higher incidence of postoperative complications (63.0% . 24.0%). In the Kaplan-Meier analysis, overall survival (OS) and disease-free survival (DFS) of the high power group were both better than the low power group. We found through Cox regression analysis that smoking, tumor volume, tumor differentiation, gene mutation, neutrophil count, and lymphocyte count were independent factors affecting the OS of patients. Based on the above factors, we constructed a nomogram, with areas under the curve (AUCs) of 0.941, 0.903, and 0.905 for predicting 1-, 2-, and 3-year OS after MWA, respectively.

CONCLUSIONS

While high-power MWA brings better long-term prognosis to patients, it also leads to an increase in postoperative complications. The application of a nomogram for stratifying the prognosis of patients may be a more feasible approach to further develop individualized treatment plans.

摘要

背景

微波消融(MWA)是治疗肺癌的重要方法,但在功率选择方面仍缺乏标准指南。本研究旨在探讨不同功率水平下MWA的有效性和安全性。

方法

本研究收集了2012年1月至2020年12月期间接受MWA治疗肺癌的患者。根据MWA的功率将所有患者分为低功率组和高功率组。通过组间比较,明确两组之间的差异。

结果

本研究共纳入265例参与者,其中低功率组192例,高功率组73例。与低功率组相比,高功率组术后并发症发生率显著更高(63.0%对24.0%)。在Kaplan-Meier分析中,高功率组的总生存期(OS)和无病生存期(DFS)均优于低功率组。通过Cox回归分析,我们发现吸烟、肿瘤体积、肿瘤分化、基因突变、中性粒细胞计数和淋巴细胞计数是影响患者OS的独立因素。基于上述因素,我们构建了一个列线图,预测MWA后1年、2年和3年OS的曲线下面积(AUC)分别为0.941、0.903和0.905。

结论

虽然高功率MWA为患者带来了更好的长期预后,但也导致术后并发症增加。应用列线图对患者预后进行分层可能是进一步制定个体化治疗方案的更可行方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/11388260/0b9d6c88c937/jtd-16-08-5031-f1.jpg

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