Background: To evaluate the efficacy and safety of microwave ablation (MWA) followed by immediate biopsy in the treatment of non-small cell lung cancer (NSCLC) and to clarify whether pathology changes can predict treatment responses and patient survival.
Methods: Patients with pathologically confirmed NSCLC pre-ablation were treated with MWA, and immediate biopsy was carried out right after ablation in one procedure. Pathology changes were categorized according to the pre- and postablation pathology: Group A, same histology type; Group B, paired histology type with burning degeneration; Group C, no definite histology type; Group D, no definite cancer cells. The internal correlations between pathology changes and baseline characteristics, responses to MWA and survival were evaluated.
Results: A total of 68 patients were enrolled in the study, of which 19, 28, 11 and 10 patients were classified into Group A, Group B, Group C and Group D, respectively. In total, 85.3 and 69.1% patients were diagnosed with malignant tumors and the same pathology type, respectively. No significant difference in clinical-pathologic characteristics or response to MWA between the groups was observed. Upon combining Groups A, B and C, Group D exhibited longer progression-free survival (PFS) (Groups A + B + C versus Group D, 11.7 months, 95% CI 9.6-13.7 versus 26.6 months, 95% CI 19.0-34.2, p = .253) and overall survival (OS) (15.9 months, 95% CI 14.2-17.5, versus 29.8 months, 95% CI, 24.3-35.3, p = .395), although no significant differences were observed. Complications were identified in 63 (92.6%), of which 17 (25.0%) patients had major complications.
Conclusions: Immediate biopsy post-MWA can distinguish cancer cells or histology types in most cases of NSCLC. However, pathology changes pre- and postablation could not predict the response to MWA and patient survival.
Keywords: Non-small cell lung cancer; changes in pathology; microwave ablation.