Computed tomography-guided microwave ablation for non-small cell lung cancer patients on antithrombotic therapy: a retrospective cohort study

Xu, Sheng; Bie, Zhi-Xin; Li, Yuanming; Li, Bin; Peng, Jin-Zhao; Kong, Fanlei; Li, Xiaoguang

doi:10.21037/qims-21-1043

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…The goals of CNB are to obtain genomic testing for previously diagnosed NSCLC or to achieve both pathological diagnosis and genomic testing for suspicious NSCLC. As described previously [ 21 ], an MTC-3 C MWA system (Vison Medicine, China) was used for ablation, with a microwave emission frequency of 2,450 ± 50 MHz and an adjustable power of 20–80 W. The MWA antennas (Vison) were 15–18 cm in effective length and 16–18 G in outside diameter, with a 15 mm active tip. Preprocedural CT was performed to conduct the ablation plan and to clarify the suitable position, puncture site location, optimal puncture trajectory, and the number of MWA antennas.…”

Section: Methodsmentioning

confidence: 99%

Percutaneous core-needle biopsy before and immediately after coaxial microwave ablation in solid non-small cell lung cancer: the comparison of genomic testing from specimens

Xu,

He,

et al. 2023

Cancer Imaging

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Purpose To compare the genomic testing based on specimens obtained from percutaneous core-needle biopsy (CNB) before and immediately after coaxial microwave ablation (MWA) in solid non-small cell lung cancer (NSCLC), and to investigate the diagnostic performance of CNB immediately after coaxial MWA in solid NSCLC. Methods Coaxial MWA and CNB were performed for NSCLC patients, with a power of 30 or 40 watts (W) in MWA between the pre- and post-ablation CNB, followed by continuous ablation after the second CNB on demand. The paired specimens derived from the same patient were compared for pathological diagnosis and genomic testing. DNA/RNA extracted from the paired specimens were also compared. Results A total of 33 NSCLC patients with solid lesions were included. There were two patients (6.1%) without atypical cells and three patients (9.1%) who had the technical failure of genomic testing in post-ablation CNB. The concordance rate of pathological diagnosis between the twice CNB was 93.9% (kappa = 0.852), while that of genomic testing was 90.9% (kappa = 0.891). For the comparisons of DNA/RNA extracted from pre- and post-ablation CNB in 30 patients, no significant difference was found when the MWA between twice CNB has a power of 30 or 40 W and ablation time within five minutes (P = 0.174). Conclusions If the pre-ablation CNB presented with a high risk of pneumothorax or hemorrhage, the post-ablation CNB could be performed to achieve accurate pathological diagnosis and genomic testing and the maximum effect of ablation, which might allow for the diagnosis of genomic testing in 90.9% of solid NSCLC.

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Section: Methodsmentioning

confidence: 99%

Percutaneous core-needle biopsy before and immediately after coaxial microwave ablation in solid non-small cell lung cancer: the comparison of genomic testing from specimens

Xu,

He,

et al. 2023

Cancer Imaging

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Safety and efficacy of percutaneous biopsy and microwave ablation in patients with pulmonary nodules on antithrombotic therapy: A study with rivaroxaban bridging

Wang,

Xue,

Zheng

et al. 2024

Thoracic Cancer

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BackgroundTo evaluate the safety and efficacy of percutaneous biopsy and microwave ablation (B + MWA) in patients with pulmonary nodules (PNs) who are receiving antithrombotic therapy by rivaroxaban as bridging therapy.MethodsThe study comprised 187 patients with PNs who underwent 187 B + MWA sessions from January 1, 2020, to December 31, 2021. The enrolled patients were divided into two groups: Group A, who received antithrombotic therapy five days before the procedure and received rivaroxaban as a bridging drug during hospitalization, and group B, who had no antithrombotic treatment. Information about the technical success rate, positive biopsy rate, complete ablative rate, and major complications were collected and analyzed.ResultsGroup A comprised 53 patients and group B comprised 134 patients. The technical success rate was 100% in both groups. The positive biopsy rates were 88.68% and 91.04%, respectively (p = 0.6211, X2 = 0.2443). In groups A and B, the complete ablative rates at 6, 12, and 24 months were 100.0% versus 99.25%, 96.23% versus 96.27%, and 88.68% versus 89.55%, respectively. There were no significant differences in bleeding and thrombotic complications between the two groups. No grade 5 complications occurred.ConclusionsIt is generally considered safe and effective that patients who are on antithrombotic therapy by rivaroxaban as bridging to undergo B + MWA for treating PNs.

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Risk factors for lung parenchyma hemorrhage and hemoptysis during computed tomography‐guided microwave ablation in patients with stage I non‐small cell lung cancer: A bicentric retrospective study

Li,

Zhang,

Chen

et al. 2024

Thoracic Cancer

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ObjectivesThis study aimed to identify the risk factors for lung parenchyma hemorrhage and hemoptysis during computed tomography‐guided microwave ablation (MWA) in patients with stage I non‐small cell lung cancer (NSCLC).MethodsA total of 417 patients from two medical centers were included, of whom 353 were from center 1 and 64 were from center 2. The risk factors for lung parenchyma hemorrhage and hemoptysis were selected by univariable and multivariable logistic analyses in the center 1 dataset. The selected risk factors were validated in the center 2 dataset.ResultsThe risk factors for lung parenchyma hemorrhage during MWA were focal blood supplies (odds ratio [OR], 2.602; 95% confidence interval [CI], 1.609–4.210; p < 0.001), near vessels larger than 2 mm (OR, 4.145; 95% CI, 1.963–8.755; p < 0.001), and traversing vessels in the track of ablation (OR, 2.961; 95% CI, 1.492–5.874; p = 0.002). The risk factors for hemoptysis were lung parenchyma hemorrhage (OR, 34.165; 95% CI, 12.255–95.247; p < 0.001), needle track traversing the lung parenchyma by >25 mm (OR, 4.494; 95% CI, 1.833–11.018; p = 0.001), and traversing vessels in the track of ablation (OR, 5.402; 95% CI, 2.269–12.865; p < 0.001).ConclusionsFocal blood supplies, near vessels larger than 2 mm, and traversing vessels in the track of ablation were independent risk factors for lung parenchyma hemorrhage during MWA. Lung parenchyma hemorrhage, needle track traversing the lung parenchyma by >25 mm, and traversing vessels in the track of ablation were independent risk factors for hemoptysis during MWA.

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Computed tomography-guided microwave ablation for non-small cell lung cancer patients on antithrombotic therapy: a retrospective cohort study

Cited by 3 publications

References 33 publications

Percutaneous core-needle biopsy before and immediately after coaxial microwave ablation in solid non-small cell lung cancer: the comparison of genomic testing from specimens

Percutaneous core-needle biopsy before and immediately after coaxial microwave ablation in solid non-small cell lung cancer: the comparison of genomic testing from specimens

Safety and efficacy of percutaneous biopsy and microwave ablation in patients with pulmonary nodules on antithrombotic therapy: A study with rivaroxaban bridging

Risk factors for lung parenchyma hemorrhage and hemoptysis during computed tomography‐guided microwave ablation in patients with stage I non‐small cell lung cancer: A bicentric retrospective study

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