Universität zu Köln

Bourgouin, Patrick P., Wrobel, Maria M., Mercaldo, Nathaniel D., Murphy, Mark C., Leppelmann, Konstantin S., Levesque, Vincent M., Muniappan, Ashok, Silverman, Stuart G., Shepard, JoAnne O., Shyn, Paul B. and Fintelmann, Florian J. (2022). Comparison of Percutaneous Image-Guided Microwave Ablation and Cryoablation for Sarcoma Lung Metastases: A 10-Year Experience. Am. J. Roentgenol., 218 (3). S. 494 - 505. LEESBURG: AMER ROENTGEN RAY SOC. ISSN 1546-3141

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Abstract

BACKGROUND. To our knowledge, outcomes between percutaneous microwave ablation (MWA) and cryoablation of sarcoma lung metastases have not been compared. OBJECTIVE. The purpose of this study was to compare technical success, complications, local tumor control, and overall survival (OS) after MWA versus cryoablation of sarcoma lung metastases. METHODS. This retrospective cohort study included 27 patients (16 women, 11 men; median age, 64 years; Eastern Cooperative Oncology Group performance score, 0-2) who, from 2009 to 2021, underwent 39 percutaneous CT-guided ablation sessions (21 MWA and 18 cryoablation sessions; one to four sessions per patient) to treat 65 sarcoma lung metastases (median number of tumors per patient, one [range, one to 121; median tumor diameter, 11.0 mm [range, 5-33 mm]; 25% of tumors were nonperipheral). We compared complications according to ablation modality by use of generalized estimating equations. We evaluated ablation modality, tumor size, and location (peripheral vs nonperipheral) in relation to local tumor progression by use of proportional Cox hazard models, with death as the competing risk. We estimated OS using the Kaplan-Meier method. RESULTS. Primary technical success was 97% for both modalities. Median follow-up was 23 months (range, one to 102 months; interquartile range, 12-44 months). A total of seven of 61 tumors (11%) showed local progression. Estimated 1-year and 2-year local control rates were, for tumors 1 cm or smaller, 97% and 95% after MWA versus 99% and 98% after cryoablation, and for tumors larger than 1 cm, 74% and 62% after MWA versus 86% and 79% after cryoablation. Tumor size of 1 cm or smaller was associated with a decreased cumulative incidence of local progression (p = .048); ablation modality and tumor location were not associated with progression (p = .86 and p = .54, respectively). Complications (Common Terminology Criteria for Adverse Events [CTCAE] grade, <= 3) occurred in 17 of 39 sessions (44%), prompting chest tube placement in nine (23%). There were no CTCAE grade 4 or 5 complications. OS at 1, 2, and 3 years was 100%, 89%, and 82%, respectively. CONCLUSION. High primary technical success, local control, and OS supportthe use of MWA and cryoablation for treating sarcoma lung metastases. Ablation modality and tumor location did not affect local progression. The rate of local tumor progression was low, especially for small tumors. No life-threatening complications occurred. CLINICAL IMPACT. Percutaneous MWA and cryoablation are both suited for the treatment of sarcoma lung metastases, especially for tumors 1 cm or smaller, whether peripheral or nonperipheral. Complications, if they occur, are not life-threatening.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bourgouin, Patrick P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wrobel, Maria M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mercaldo, Nathaniel D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Murphy, Mark C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leppelmann, Konstantin S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Levesque, Vincent M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muniappan, Ashok UNSPECIFIED UNSPECIFIED UNSPECIFIED Silverman, Stuart G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shepard, JoAnne O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shyn, Paul B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fintelmann, Florian J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-684195
DOI:	10.2214/AJR.21.26551
Journal or Publication Title:	Am. J. Roentgenol.
Volume:	218
Number:	3
Page Range:	S. 494 - 505
Date:	2022
Publisher:	AMER ROENTGEN RAY SOC
Place of Publication:	LEESBURG
ISSN:	1546-3141
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BODY RADIATION-THERAPY; RADIOFREQUENCY ABLATION; PULMONARY METASTASES; TUMORS; SURVIVAL; CANCER; MULTICENTER; RESECTION; SAFETY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68419