Geevarghese Ruben, Alexander Erica S, Elsakka Ahmed, Chevallier Olivier, Kelly Luke, Sotirchos Vlasios S, Sofocleous Constantinos T, Petre Elena N, Erinjeri Joseph P, Zhan Chenyang, Ridouani Fourat, Jiang Liwei, Keshavamurthy Krishna Nand, Salkin Robert S, Yarmohammadi Hooman, Solomon Stephen B, Ziv Etay
Division of Interventional Radiology, Department of Radiology, Room H118, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon, France.
Eur Radiol. 2025 Sep 17. doi: 10.1007/s00330-025-11973-8.
Percutaneous ablation is a treatment modality used in the management of primary and metastatic lung malignancies. Factors affecting local control rate (LCR) following microwave ablation (MWA) are poorly understood due to inconsistent and limited reporting of histology and procedure-related outcomes.
Single-center retrospective study of patients with primary and metastatic lung malignancies who underwent MWA between January 2010 and July 2021. Patient, tumor and ablation characteristics were recorded. Outcomes evaluated included technical success, local tumor control and adverse events (AEs).
A total of 669 nodules were identified from 383 patients (197 male/186 female with a median age of 59 years (IQR = 21 years)) across 459 ablation sessions. This comprised 83 primary and 586 metastatic lung tumors. One-year and two-year local LCRs (±SD) across the cohort were 90.3% (±1.1%) and 84.7% (±1.4%), respectively. Multivariable analysis identified ablation power settings, age, concomitant chemotherapy and histology as significant covariates associated with time to local recurrence (TTLR). Standard power was associated with longer TTLR, compared to low power, with no significant difference in AE rates. A significant difference in TTLR was noted between different histological groups.
MWA of primary and metastatic lung tumors is safe and effective. LCRs differ across different histologies. Standard power MWA is associated with longer TTLR without increased AEs rates.
Question Reported local control rates for microwave ablation (MWA) vary widely, with limited and heterogeneous data on histology-specific and parameter-related outcomes, leaving a gap in understanding. Findings MWA achieved 90.3% and 84.7% one- and two-year local control rates, with longer time to recurrence for standard power MWA. Histology-specific differences noted in time to recurrence. Clinical relevance MWA is a safe and effective treatment for primary and secondary lung cancers, offering comparable local control rates to radiotherapy and surgical resection. Further refinement of treatment parameters may enhance outcomes and address histology-specific challenges.
经皮消融是用于治疗原发性和转移性肺恶性肿瘤的一种治疗方式。由于组织学和手术相关结果的报告不一致且有限，对微波消融（MWA）后局部控制率（LCR）的影响因素了解不足。
对2010年1月至2021年7月期间接受MWA的原发性和转移性肺恶性肿瘤患者进行单中心回顾性研究。记录患者、肿瘤和消融特征。评估的结果包括技术成功、局部肿瘤控制和不良事件（AE）。
在459次消融治疗中，共从383例患者（197例男性/186例女性，中位年龄59岁（IQR = 21岁））中识别出669个结节。其中包括83个原发性和586个转移性肺肿瘤。该队列的1年和2年局部LCR（±标准差）分别为90.3%（±1.1%）和84.7%（±1.4%）。多变量分析确定消融功率设置、年龄、同步化疗和组织学是与局部复发时间（TTLR）相关的显著协变量。与低功率相比，标准功率与更长的TTLR相关，AE发生率无显著差异。不同组织学组之间的TTLR存在显著差异。
原发性和转移性肺肿瘤的MWA安全有效。不同组织学的LCR不同。标准功率MWA与更长的TTLR相关，且AE发生率未增加。
问题 报告的微波消融（MWA）局部控制率差异很大，关于组织学特异性和参数相关结果的数据有限且不统一，在理解方面存在差距。发现 MWA的1年和2年局部控制率分别为90.3%和84.7%，标准功率MWA的复发时间更长。在复发时间上存在组织学特异性差异。临床意义 MWA是治疗原发性和继发性肺癌的一种安全有效的方法，其局部控制率与放疗和手术切除相当。进一步优化治疗参数可能会改善治疗效果并应对组织学特异性挑战。
