Microwave Ablation Versus Wedge Resection for Stage I Non-small Cell Lung Cancer Adjacent to the Pericardium: Propensity
- PDF / 951,171 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 178 Views
CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Microwave Ablation Versus Wedge Resection for Stage I Nonsmall Cell Lung Cancer Adjacent to the Pericardium: Propensity Score Analyses of Long-term Outcomes Hao Hu1 • Bo Zhai2
•
Rong Liu2 • Jia chang Chi1
Received: 6 December 2019 / Accepted: 15 July 2020 The Author(s) 2020
Abstract Objective The present study has compared the long-term outcomes between performing wedge resection (WR) and microwave ablation (MWA) as first-line treatment of stage I non–small cell lung cancer (NSCLC) patients with tumors adjacent to the pericardium. Materials and Methods Between January 2014 and December 2018, a total of 223 consecutive patients with T1N0 NSCLC underwent first-line treatment by WR (n = 155) or image-guided lung MWA (n = 68). This study has compared the progression-free survival (PFS) and overall survival (OS) rates between the two treatments before and after propensity score matching. Subgroup analysis of these outcomes was conducted based on the distance from the pericardium. Results The median follow-up time was 47 months. Propensity matching yielded 56 pairs of patients. In the two matched groups, the PFS rates in the WR group at 3 and 5 years were 66.0% and 56.0% and 54.0% and 36.0%, respectively, in the MWA group (P = 0.029). Meanwhile, the corresponding OS rates for the WR group at 3 and
& Bo Zhai [email protected] & Rong Liu [email protected] & Jia chang Chi [email protected] 1
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2
Department of Interventional Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
5 years were 81.0% and 72.0% and 60.0% and 55.0% in the MWA group, respectively (P = 0.031). Subgroup analysis, done according to the treatment modality, indicated that local tumor recurrence and PFS for NSCLCs that were close but not contiguous to the pericardium were different from those contiguous to the pericardium (P = 0.018 and P = 0.025, respectively). Conclusion WR provided better long-term tumor control and OS compared to MWA for stage I NSCLC adjacent to the pericardium as a first-line treatment. MWA can be considered as an alternative option for high-risk and inoperable patients, particularly for tumors that were not contiguous to the pericardium.
Introduction Lung cancer accounts for the highest number of cancerrelated deaths globally [1]. Anatomic lung resection represents the standard curative therapy for patients with early-stage non–small cell lung cancer (NSCLC). However, approximately 30% of patients are not eligible for surgery because of various reasons, including detection at an advanced-stage, medical comorbidities, insufficient cardiopulmonary function, or poor performance scores [2]. One minimal invasive therapy is percutaneous microwave ablation (MWA), which has emerged as the preferred therapeutic strategy for patients who are not to undergo operation [3, 4]. MWA is minimally invasive, as it only c
Data Loading...
