Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors

Li,Hong-Wei; Long,Yong-Jun; Yan,Gao-Wu; Bhetuwal,Anup; Zhuo,Li-Hua; Yao,Hong-Chao; Zhang,Jie; Zou,Xing-Xiong; Hu,Pei-Xi; Yang,Han-Feng; Du,Yong

doi:10.3892/mco.2022.2495

Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors

Authors:
- Hong-Wei Li
- Yong-Jun Long
- Gao-Wu Yan
- Anup Bhetuwal
- Li-Hua Zhuo
- Hong-Chao Yao
- Jie Zhang
- Xing-Xiong Zou
- Pei-Xi Hu
- Han-Feng Yang
- Yong Du
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Affiliations: Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan 621000, P.R. China, Department of Radiology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China, Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
Published online on: January 14, 2022 https://doi.org/10.3892/mco.2022.2495
Article Number: 62
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

At present, minimally invasive surgery is one of the primary strategies for the treatment of malignant pulmonary tumors. Although, there are some comparative studies between microwave ablation and radiofrequency for the treatment of malignant pulmonary tumors, there are few studies that have investigated the comparison between microwave ablation and cryoablation. The aim of the study was to retrospectively compare the efficacy and complications of microwave ablation (MWA) and cryoablation in the treatment of malignant pulmonary tumors. A retrospective analysis was performed on 48 patients with malignant lung tumors treated with MWA or cryoablation in The Third Hospital of Mianyang and The Affiliated Hospital of North Sichuan Medical College between June 2014 and June 2018. Of these patients, 29 received MWA and 19 received cryoablation. Intraprocedural pain was evaluated by using the visual analog scale (VAS). The intraprocedural pain, response rates, overall survival (OS) and complications rates were compared between the MWA group and cryoablation group. The results showed that the patients in the MWA group experienced more pain than those in cryoablation group as the MWA group VAS scores were much higher than those in cryoablation group (P<0.001). The overall response rate of the MWA group [21/29 (72.41%)] was not significantly different from the cryoablation group [14/19 (73.68%)] (P=0.92). The 6‑, 12‑, 24‑ and 36‑month OS rates in the MWA group and cryoablation group were 92.72, 81.28, 64.54 and 54.91%, and 94.07, 81.13, 57.33 and 43.04%, respectively. No significant differences were found in the OS rate between the two groups (P=0.79). The complication rates in the MWA and cryoablation groups were 34.48 and 36.84%, respectively; there was no significant difference between the two groups (P=0.59). No patients died during the perioperative period. Cryoablation had a similar therapeutic effect compared with MWA in the treatment of pulmonary malignant tumors, but was associated with less pain.

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1	Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J and Jemal A: Global cancer statistics, 2012. CA Cancer J Clin. 65:87–108. 2015.PubMed/NCBI View Article : Google Scholar
2	Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D and Bray F: Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 136:E359–E386. 2015.PubMed/NCBI View Article : Google Scholar
3	Oudkerk M, Liu S, Heuvelmans MA, Walter JE and Field JK: Lung cancer LDCT screening and mortality reduction-evidence, pitfalls and future perspectives. Nat Rev Clin Oncol. 18:135–151. 2021.PubMed/NCBI View Article : Google Scholar
4	Nomori H, Yamazaki I, Machida Y, Otsuki A, Cong Y, Sugimura H and Oyama Y: Lobectomy versus segmentectomy: A propensity score-matched comparison of postoperative complications, pulmonary function and prognosis. Interact Cardiovasc Thorac Surg. 25(ivab212)2021.PubMed/NCBI View Article : Google Scholar
5	Akalin A, Mu X, Kon MA, Ergin A, Remiszewski SH, Thompson CM, Raz DJ, Diem M, Bird B and Miljković M: Classification of malignant and benign tumors of the lung by infrared spectral histopathology (SHP). Lab Invest. 95(697)2015.PubMed/NCBI View Article : Google Scholar
6	Du S, Qin D, Pang R, Zhang Y, Zhao S, Hu M and Zhi X: Long-term efficacy of radiofrequency ablation combined with chemotherapy in the treatment of patients with advanced non-small cell lung cancer-a retrospective study. Zhongguo Fei Ai Za Zhi. 20:675–682. 2017.PubMed/NCBI View Article : Google Scholar : (In Chinese).
7	Sonntag PD, Hinshaw JL, Lubner MG, Brace CL and Lee FT Jr: Termal ablation of lung tumors. Surg Oncol Clin N Am. 20:369–387. 2011.PubMed/NCBI View Article : Google Scholar
8	Erinjeri JP and Clark TW: Cryoablation: Mechanism of action and devices. J Vasc Interv Radiol. 21 (8 Suppl):S187–S191. 2010.PubMed/NCBI View Article : Google Scholar
9	Lee S, Rhim H, Kim YS, Choi D, Lee WJ, Lim HK and Shin B: Percutaneous radiofrequency ablation of hepatocellular carcinomas: Factors related to intraprocedural and postprocedural pain. AJR Am J Roentgenol. 192:1064–1070. 2009.PubMed/NCBI View Article : Google Scholar
10	Dueck AC, Mendoza TR, Mitchell SA, Reeve BB, Castro KM, Rogak LJ, Atkinson TM, Bennett AV, Denicoff AM, O'Mara AM, et al: National cancer institute PRO-CTCAE study group. Validity and reliability of the US National cancer institute's patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). JAMA Oncol. 1:1051–1059. 2015.PubMed/NCBI View Article : Google Scholar
11	Ahmed M: Technology Assessment Committee of the Society of Interventional Radiology. Image-guided tumor ablation: Standardization of terminology and reporting criteria-a 10-year update: supplement to the consensus document. J Vasc Interv Radiol. 25:1706–1708. 2014.PubMed/NCBI View Article : Google Scholar
12	Bojarski JD, Dupuy DE and Mayo-Smith WW: CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: Results in 32 tumors. AJR Am J Roentgenol. 185:466–471. 2005.PubMed/NCBI View Article : Google Scholar
13	Tsuchida Y and Therasse P: Response evaluation criteria in solid tumors (RECIST): New guidelines. Med Pediatr Oncol. 37:1–3. 2001.PubMed/NCBI View Article : Google Scholar
14	Dupuy DE: Image-guided thermal ablation of lung malignancies. Radiology. 260:633–655. 2011.PubMed/NCBI View Article : Google Scholar
15	Howington JA, Blum MG, Chang AC, Balekian AA and Murthy SC: Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of chest physicians evidence-based clinical practice guidelines. Chest. 143 (5 Suppl):e278S–e313S. 2013.PubMed/NCBI View Article : Google Scholar
16	Yao W, Lu M, Fan W, Huang J, Gu Y, Gao F, Wang Y, Li J and Zhu Z: Comparison between microwave ablation and lobectomy for stage I non-small cell lung cancer: A propensity score analysis. Int J Hyperthermia. 34:1329–1336. 2018.PubMed/NCBI View Article : Google Scholar
17	Yang X, Ye X, Huang G, Han X, Wang J, Li W, Wei Z and Meng M: Repeated percutaneous microwave ablation for local recurrence of inoperable Stage I nonsmall cell lung cancer. J Cancer Res Ther. 13:683–688. 2017.PubMed/NCBI View Article : Google Scholar
18	Vogl TJ, Roman A, Nour-Eldin NA, Hohenforst-Schmidt W, Bednarova I and Kaltenbach B: A comparison between 915 MHz and 2450 MHz microwave ablation systems for the treatment of small diameter lung metastases. Diagn Interv Radiol. 24:31–37. 2018.PubMed/NCBI View Article : Google Scholar
19	Gage AA and Baust J: Mechanisms of tissue injury in cryosurgery. Cryobiology. 37:171–186. 1998.PubMed/NCBI View Article : Google Scholar
20	Hoffmann NE and Bischof JC: The cryobiology of cryosurgical injury. Urology. 60 (2 Suppl 1):S40–S49. 2002.PubMed/NCBI View Article : Google Scholar
21	Kawamura M, Izumi Y, Tsukada N, Asakura K, Sugiura H, Yashiro H, Nakano K, Nakatsuka S, Kuribayashi S and Kobayashi K: Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates. J Thorac Cardiovasc Surg. 131:1007–1013. 2006.PubMed/NCBI View Article : Google Scholar
22	Inoue M, Nakatsuka S, Yashiro H, Ito N, Izumi Y, Yamauchi Y, Hashimoto K, Asakura K, Tsukada N, Kawamura M, et al: Percutaneous cryoablation of lung tumors: Feasibility and safety. J Vasc Interv Radiol. 23:295–302. 2012.PubMed/NCBI View Article : Google Scholar
23	Pusceddu C, Sotgia B, Fele RM and Melis L: CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience. Eur J Radiol. 82:e246–e253. 2013.PubMed/NCBI View Article : Google Scholar
24	Li M, Liu J, Zhang SZ, Zhou Y, Guo YW, Chen Q, Ke YQ, Jiang XD and Cai YQ: Cellular immunologic response to primary cryoablation of C6 gliomas in rats. Technol Cancer Res Treat. 10:95–100. 2011.PubMed/NCBI View Article : Google Scholar
25	Das SK, Huang YY, Li B, Yu XX, Xiao RH and Yang HF: Comparing cryoablation and microwave ablation for the treatment of patients with stage IIIB/IV non-small cell lung cancer. Oncol Lett. 19:1031–1041. 2020.PubMed/NCBI View Article : Google Scholar
26	Martin RC, Scoggins CR and McMasters KM: Microwave hepatic ablation: Initial experience of safety and efficacy. J Surg Oncol. 96:481–486. 2007.PubMed/NCBI View Article : Google Scholar
27	Wright AS, Lee FT Jr and Mahvi DM: Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol. 3:275–283. 2003.PubMed/NCBI View Article : Google Scholar
28	Berber E: Laparoscopic microwave thermosphere ablation of malignant liver tumors: An initial clinical evaluation. Surg Endosc. 30:692–698. 2016.PubMed/NCBI View Article : Google Scholar
29	Ma Y, Wallace AN, Waqar SN, Morgensztern D, Madaelil TP, Tomasian A and Jennings JW: Percutaneous image-guided ablation in the treatment of osseousmetastases from non-small cell lung cancer. Cardiovasc Intervent Radiol. 41:726–733. 2018.PubMed/NCBI View Article : Google Scholar
30	Wei YT and Xiao YY: Expert consensus for image-guided cryoblation of lung cancer (In Chinese). Chin J Interv Imaging Ther. 15:259–263. 2018.
31	Yashiro H, Nakatsuka S, Inoue M, Kawamura M, Tsukada N, Asakura K, Yamauchi Y, Hashimoto K and Kuribayashi S: Factors affecting local progression after percutaneous cryoablation of lung tumors. J Vasc Interv Radiol. 24:813–821. 2013.PubMed/NCBI View Article : Google Scholar