Microwave ablation of refractory oligometastatic non–small cell lung cancer in the liver Journal Article
| Authors: | Geevarghese, R.; Kunin, H.; Petre, E. N.; Deng, R.; Jain, S.; Sotirchos, V. S.; Zhao, K.; Sofocleous, C. T.; Solomon, S. B.; Ziv, E.; Alexander, E. |
| Article Title: | Microwave ablation of refractory oligometastatic non–small cell lung cancer in the liver |
| Abstract: | Purpose: To evaluate safety and effectiveness of microwave ablation (MWA) in the treatment of liver metastases (LMs) secondary to non–small cell lung cancer (NSCLC). Materials and Methods: 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. Results: 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. Conclusions: Percutaneous MWA was a safe treatment for NSCLC LM, with longer survival noted in younger patients and those without synchronous lung tumors. © 2024 SIR |
| Keywords: | adult; aged; middle aged; survival analysis; survival rate; major clinical study; overall survival; constipation; fatigue; gemcitabine; cancer patient; follow up; cohort analysis; retrospective study; age; risk assessment; coughing; dyspnea; fever; hypoxia; lung embolism; liver metastasis; lung metastasis; minimal residual disease; cancer size; clinical evaluation; patient safety; predictor variable; clinical effectiveness; observational study; multiple cancer; disease exacerbation; descriptive research; abscopal effect; non small cell lung cancer; molecularly targeted therapy; tumor ablation; clinical outcome; shoulder pain; chest tightness; survival prediction; upper abdominal pain; refractory cancer; dabrafenib; trametinib; Common Terminology Criteria for Adverse Events; hand pain; intention to treat analysis; human; male; female; article; median survival time; ecog performance status; microwave thermotherapy; pain severity; local tumor progression free survival; local progression free survival; procedural pain; tumor margin |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 36 |
| Issue: | 2 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2025-02-01 |
| Start Page: | 266 |
| End Page: | 273 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2024.10.017 |
| PUBMED: | 39447638 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Erica Alexander -- Source: Scopus |
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422Solomon -
244Sofocleous -
108Petre -
111Ziv -
53Sotirchos -
23
Kunin -
36Alexander -
35Zhao -
14
Geevarghese
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