Repeated percutaneous microwave ablation for local recurrence of inoperable Stage I nonsmall cell lung cancer

Abstract

Background: The safety and effectiveness of repeated computed tomography-guided percutaneous microwave ablation (MWA) in the management of local recurrence (LR) in patients with medically inoperable Stage I nonsmall cell lung cancer (NSCLC) were retrospectively evaluated. Materials and Methods: From February 2008 to August 2014, 104 patients with medically inoperable Stage I NSCLC received MWA. Patients with LR were given repeat MWA. The clinical outcomes and complications of repeat MWA for LR were evaluated. Results: At a median follow-up of 47 months, LR occurred in 24/104 (23.1%) patients within 12 ± 8 months after MWA. LR rates were higher in tumors >3.5 cm than that of tumors ≤3.5 cm (35.7% vs. 18.4%). Local control of the repeat MWA was achieved in 21 of 24 (87.5%) patients. Overall survival (OS) and progress-free survival (PFS) for patients without LR were similar to that of with LR and receiving repeat MWA (OS: 48 m vs. 41.5 m; PFS: 42 m vs. 32 m). The OS rates were 100%, 74.6%, 60.6%, and 27% for patients without LR at 1, 2, 3, and 5 years, and they were 96.4%, 69.5%, 60.6%, and 26.1% for patients with repeat MWA for LR. Repeat MWA for LR was not associated with more significant complications. Conclusion: The LR was higher in tumors >3.5 cm than that of in tumors ≤3.5 cm. For patients with LR, it was feasible and effective to use MWA repeatedly to achieve the similar OS and PFS as patients without LR. No additional complications were reported in the repeat MWA compared to the original MWA.