Geevarghese Ruben, Kunin Henry, Petre Elena N, Deng Rebecca, Jain Samagra, Sotirchos Vlasios S, Zhao Ken, Sofocleous Constantinos T, Solomon Stephen B, Ziv Etay, Alexander Erica
Division of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Hospital Administration, Northwell Health, Lennox Hill Hospital, New York, New York.
J Vasc Interv Radiol. 2025 Feb;36(2):266-273. doi: 10.1016/j.jvir.2024.10.017. Epub 2024 Oct 22.
To evaluate safety and effectiveness of microwave ablation (MWA) in the treatment of liver metastases (LMs) secondary to non-small cell lung cancer (NSCLC).
This retrospective study included patients with NSCLC who underwent MWA of LM from March 2015 to July 2022. Local tumor progression-free survival (LTPFS) and overall survival (OS) were estimated using competing risk analysis and the Kaplan-Meier method. Postprocedural adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Twenty-three patients with 32 LMs were treated in 27 MWA sessions. The mean dimension of the largest index tumor was 1.96 cm (SD ± 0.75). Technical success was 100%. Technical effectiveness was achieved in 26 (81.3%) of 32 tumors. The median length of follow-up was 37.7 months (interquartile range, 20.5-54.5 months). The median LTPFS was 16.3 months (95% confidence interval [CI], 7.87-44.10 months). The median OS was 31.7 months (95% CI, 11.1-65.8 months). Ablation margin was a significant factor for LTPFS, with tumors ablated without a measurable margin being more likely to progress than those with measurable margins (subdistribution hazard ratios [HRs], 0.008-0.024; P < .001). Older age (HR, 1.18; 95% CI, 1.09-1.28; P < .001) and presence of synchronous lung metastases (HR, 14.73; 95% CI, 1.86-116.95; P = .011) were significant predictors of OS. Serious adverse events (CTCAE Grade ≥3) within 30 days occurred in 2 (7.4%) of 27 sessions, including pulmonary embolus and severe abdominal pain.
Percutaneous MWA was a safe treatment for NSCLC LM, with longer survival noted in younger patients and those without synchronous lung tumors.
评估微波消融（MWA）治疗非小细胞肺癌（NSCLC）继发性肝转移瘤（LMs）的安全性和有效性。
这项回顾性研究纳入了2015年3月至2022年7月期间接受LM的MWA治疗的NSCLC患者。使用竞争风险分析和Kaplan-Meier方法估计局部无肿瘤进展生存期（LTPFS）和总生存期（OS）。根据不良事件通用术语标准（CTCAE）v5.0记录术后不良事件。
23例患者的32个LMs接受了27次MWA治疗。最大索引肿瘤的平均直径为1.96 cm（标准差±0.75）。技术成功率为100%。32个肿瘤中有26个（81.3%）实现了技术有效性。中位随访时间为37.7个月（四分位间距，20.5 - 54.5个月）。中位LTPFS为16.3个月（95%置信区间[CI]，7.87 - 44.10个月）。中位OS为31.7个月（95%CI，11.1 - 65.8个月）。消融边缘是LTPFS的一个重要因素，与有可测量边缘的肿瘤相比，无可测量边缘消融的肿瘤更易进展（亚分布风险比[HRs]，0.008 - 0.024；P <.001）。年龄较大（HR，1.18；95%CI，1.09 - 1.28；P <.001）和存在同步肺转移（HR，14.73；95%CI，1.86 - 116.95；P =.011）是OS的显著预测因素。27次治疗中有2次（7.4%）在30天内发生严重不良事件（CTCAE≥3级），包括肺栓塞和严重腹痛。
经皮MWA是治疗NSCLC-LM的一种安全方法，年轻患者和无同步肺肿瘤患者的生存期更长。
