4:06 PM; Abstract No. 207 - Surgifoam for needle track embolization after percutaneous lung biopsy and/or fiducial marker placement reduces the rate of pneumothorax and chest tube placement

Abstract

Purpose: To expand on preliminary studies on the safety and efficacy of microwave ablation (MWA) of lung malignancies using a larger data set and longer term follow-up than previously published. Materials and Methods: 108 patients (42 female, 66 male, mean age 73 years) received outpatient CT guided percutaneous microwave ablation for a single lung malignancy. Patient data, including procedural reports, hospital and outpatient oncology clinical records, as well as follow-up contrast enhanced CT and PET scans, were retrospectively reviewed. Kaplan-Meier modelling and logistic regression were used. Results: The odds of success are 11.1 times higher for o3 cm tumor vs 43 cm, 95% CI[2.97,41.1], p1⁄4.0003. Tumor type had no effect on technical success. The odds of complication of any kind were 2 times higher for 43cm tumors vs o3cm, though this trended toward significance, p1⁄4.09. For every mm increase in original tumor maximal diameter (OMD), the odds of not attaining success increased by 7%, 95% CI[3%,10%], p1⁄4.0002. Likewise, for every mm increase in OMD, the odds of one or more complications increased by 3%, 95% CI [.1%,5%], p1⁄4.04. The median time for tumor reoccurrence was 62 months, 95% CI [29,na]. Reccurrence was estimated at 22% 36% and 44% for 1, 2 and 3 years, respectively. The median time of cancer-related death was 42 mo, 95% CI[38,na]. In addition, reccurrence was estimated at 31% at 13 mo for tumors 43cm and 17% for those o3cm. Medians could not be estimated due to low event rate for tumors o3cm, only the first quartile was estimated: 24 mo for tumors o3cm and 10 mo for 43cm; this difference trended toward significance, p1⁄4.0513. 54% of patients had one or more complications of various severities including: pneumothorax 32%, bronchopleural fistula 2%, hospital admission 28%, pain 20%, infection 7%, postablation syndrome 4%, and ARDS 4%. No relationship was found for pneumothorax with size or cancer type. Conclusion: This study further supports the safe and effective use of outpatient MWA for the treatment of lung malignancies. Details regarding tumor characteristics and procedural methods will help define appropriate patient selection and treatment technique. 4:06 PM Abstract No. 207