Microwave ablation for non-small cell lung cancer with synchronous solitary extracranial metastasis

J Cancer Res Clin Oncol. 2020 May;146(5):1361-1367. doi: 10.1007/s00432-020-03176-z. Epub 2020 Mar 7.

Abstract

Aims: Local therapy including surgery or radiotherapy has been reported for the treatment of non-small cell lung cancer (NSCLC) with synchronous solitary metastasis, while studies with other local ablative treatment are rare. Here, we summarized our single-center experience of microwave ablation (MWA) for both primary and metastatic lesions in NSCLC patients with synchronous solitary extracranial metastases.

Patients and methods: We retrospectively screened our institute database from January 2014 to Jun 2019. NSCLC patients with synchronous extracranial solitary metastasis with primary and metastatic lesions that were treated with MWA were identified and analyzed.

Results: Of the 1472 stage IV NSCLC patients found, 38 were diagnosed with synchronous extracranial solitary metastasis and 29 of them received MWA for primary and metastatic lesions. The most common distant metastases were contralateral lung metastases (14 cases), followed by bone (6), liver (4), adrenal gland (3) and pleura metastases (1). Median OS and PFS was 21.5 and 12.5 months, respectively. Patients with N0 had significantly longer PFS (median 18.5 vs. 8.0 months) and OS (median 42.7 vs. 19.0 months). In addition, systemic therapy was showed to be a prognostic factor for better PFS (12.9 vs. 7.5 months). Clinical pathological factors including age, histology, T stage, PS score, and metastasis locations are not significantly associated with survival.

Conclusions: MWA may serve as an alternative treatment for NSCLCs with synchronous solitary extracranial metastases.

Keywords: Microwave ablation; Non-small cell lung cancer; Synchronous solitary metastases; Thermal ablation.

MeSH terms

  • Aged
  • Brain Neoplasms
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / surgery*
  • Male
  • Microwaves / adverse effects
  • Microwaves / therapeutic use*
  • Middle Aged
  • Progression-Free Survival
  • Radiofrequency Ablation / adverse effects
  • Radiofrequency Ablation / methods*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome