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Percutaneous lung microwave ablation versus lung resection in high-risk patients. A monocentric experience

BACKGROUND AND AIM OF WORK: Lung microwave ablation (MWA) is considered an alternative treatment in high-risk patients, not suitable for surgery. The aim of our study is to compare MWA and pulmonary lobectomy in high-risk, lung cancer patients. METHODS: This was a single-center, propensity score-wei...

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Detalles Bibliográficos
Autores principales: Mendogni, Paolo, Daffrè, Elisa, Rosso, Lorenzo, Palleschi, Alessandro, Righi, Ilaria, Carrinola, Rosaria, Damarco, Francesco, Polli, Federico, Ierardi, Annamaria, Arrichiello, Antonio, Carrafiello, Gianpaolo, Nosotti, Mario, Tosi, Davide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023078/
https://www.ncbi.nlm.nih.gov/pubmed/33245066
http://dx.doi.org/10.23750/abm.v91i10-S.10342
Descripción
Sumario:BACKGROUND AND AIM OF WORK: Lung microwave ablation (MWA) is considered an alternative treatment in high-risk patients, not suitable for surgery. The aim of our study is to compare MWA and pulmonary lobectomy in high-risk, lung cancer patients. METHODS: This was a single-center, propensity score-weighted cohort study. All adult patients who underwent CT guided MWA for stage I NSCLC between June 2009-October 2014 were included in the study and were compared with a cohort of patients submitted to lung lobectomy in the same period of time. Outcomes were overall survival (OS) and disease-free survival (DFS). RESULTS: 32 patients underwent MWA, and 35 high-risk patients submitted to lung lobectomy in the same period were selected. Median follow-up time was 51.1 months (95% CI: 43.8-62.3). Overall survival was 43.8 (95% CI: 26.1-55) and 55.8 months (95% CI: 49.9-76.8) in the MWA group and Lobectomy group, respectively. Negative prognostic factors were MWA procedure (HR:2.25, 95% CI: 1.20-4.21, p= 0.0109) and nodule diameter (HR: 1.04, 95% CI: 1.01-1.07; p= 0.007) for OS, while MWA procedure (HR: 5.2; 95% CI: 2.1-12.8: p < 0.001), ECOG 3 (HR: 5.0; 95% CI: 1.6-15.6; p = 0.006) and nodule diameter (HR: 1.1; 95% CI: 1.0-1.1; p = 0.003) for DFS. CONCLUSIONS: Our study demonstrated a high percentage of local relapse in the MWA group but a comparable overall survival. Although lung lobectomy remains the gold standard treatment for stage I NSCLC, we can consider the MWA procedure as valid alternative local treatment in high-risk patients for stage I NSCLC. (www.actabiomedica.it)