CT-guided microwave ablation for large inoperable pulmonary metastases from sarcoma: a case series

Objectives This study aimed to retrospectively evaluate the feasibility, efficacy and safety of percutaneous computed tomography (CT)-guided microwave ablation (MWA) for the treatment of large inoperable pulmonary metastases from sarcoma. Materials and Methods The study was approved by the institutional review board, and informed consent was obtained from all patients. From January 1, 2011, to May 1, 2018, 15 patients with sarcoma (9 males and 6 females; median age 35 years) with 17 large inoperable pulmonary metastases from sarcoma (mean size, 7.6 ± 1.7 cm; range, 5.0-10.8 cm) received percutaneous CT-guided microwave ablation. The treatment efficacy, complications and overall survival were evaluated. Results The median follow-up was 24.6 months (range 1.6—65.8 months). Complete response was achieved in 4 tumors (23.5%), partial response in 11 tumors (64.7%), while 2 tumors (11.8%) demonstrated disease progression. The 1-, 2- and 3-year overall survival rates were 78.6%, 69.8% and 50.9%, respectively. The median overall survival time was 39 months (95% CI 18.2-59.8 months). Curative ablation was associated with significantly improved local progression-free survival compared with palliative ablation (median LPFS: not reached vs 17.09 months; HR 4.913, 95% CI: 1.039-23.24, p = 0.046). No treatment-related death occurred. Pneumothorax was the most common complication with an incidence of 20.8%(n = 5). The median hospital stay was 5 days. Conclusion CT-guided microwave ablation appears to be a safe and effective treatment for large inoperable pulmonary metastases from sarcoma.