Safety and clinical outcomes of computed tomography-guided percutaneous microwave ablation in patients aged 80 years and older with early-stage non-small cell lung cancer: A multicenter retrospective study.

Xiaoying Han,Xin Ye,Jiao Wang,Yuanxun Qiao,Licheng Zhang,Chunhai Li,Xiangming Chen,Kun Ding,Wenhong Li,Chuandai Wang,Yuting Dong,Min Meng,Yang Ni,Xia Yang,Guanghui Huang,Zhenhua Rong,Qingliang Feng,Chuntang Wang,Zhigang Wei

doi:10.1111/1759-7714.13209

Abstract

BackgroundPrevious studies have documented the therapeutic value of computed tomography (CT)‐guided percutaneous microwave ablation (MWA) for early‐stage non‐small cell lung cancer (NSCLC). However, few studies have focused on patients aged 80 years and older. This retrospective study aimed to evaluate the safety and clinical outcomes of CT‐guided percutaneous MWA in patients aged 80 years and older with early‐stage peripheral NSCLC.MethodsA retrospective analysis of 63 patients aged 80 years and older with cT1a‐2bN0M0 peripheral NSCLC who underwent CT‐guided percutaneous MWA was performed between January 2008 and January 2018 at 11 hospitals in Shandong Province, China.ResultsThe median follow‐up time was 21.0 months. The overall median survival time was 50 months. The cancer‐specific median survival time was not reached in five years. The one‐, two‐, three‐, four‐, and five‐year overall survival rates were 97.1%, 92.6%, 63.4%, 54.4%, and 32.6%, respectively. The one‐, two‐, and three‐year cancer‐specific survival (CSS) rates were 97.9%, 97.9%, and 69.4%, respectively. The four‐ and five‐year CSS rates were not achieved. A total of 14 patients (22.2%) had local progression. The one‐, two‐, three‐, four‐, and five‐year local control rates were 88.8%, 78.8%, 70.3%, 63.9%, and 63.9%, respectively. The mortality rate was 0% within 30 days after the procedure. Major complications included pneumothorax requiring drainage (21.1%), pulmonary infection (4.2%), and pleural effusions requiring drainage (2.8%).ConclusionsCT‐guided percutaneous MWA is a safe and effective modality for treating patients aged 80 years and older with early‐stage peripheral NSCLC.

Highlights

Primary lung cancer remains the leading cause of cancerrelated death among men and women.[1]
The survival rate of patients treated with microwave ablation (MWA) in our study was better than that of untreated patients in the retrospective study
Jeppesen et al compared the clinical outcomes of patients with inoperable T1-2N0M0 non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT) to untreated patients.[17]

Summary

Introduction

Primary lung cancer remains the leading cause of cancerrelated death among men and women.[1]. In MWA, energy is not distributed by means of an electric current, which increases the heating radius in the poor thermal conduction environment of the lung.[11] Despite these benefits of MWA, the safety and clinical outcomes of MWA in geriatric patients with early-stage NSCLC are not well understood. This study aimed to evaluate whether MWA is a safe and effective therapy for patients aged 80 years and older with inoperable peripheral stage T1a-T2bN0M0 NSCLC. Previous studies have documented the therapeutic value of computed tomography (CT)-guided percutaneous microwave ablation (MWA) for early-stage non-small cell lung cancer (NSCLC). Conclusions: CT-guided percutaneous MWA is a safe and effective modality for treating patients aged 80 years and older with early-stage peripheral NSCLC

Objectives

Methods

Results

Conclusion