Percutaneous Microwave Ablation for Treatment of Retroperitoneal Tumors.

IF 5.6 Q1 ONCOLOGY Radiology. Imaging cancer Pub Date : 2024-03-01 DOI:10.1148/rycan.230080
Annika E Rossebo, Annie M Zlevor, Emily A Knott, Lu Mao, Allison B Couillard, Timothy J Ziemlewicz, J Louis Hinshaw, E Jason Abel, Meghan G Lubner, Erica M Knavel Koepsel, Shane A Wells, Lindsay M Stratchko, Paul F Laeseke, Fred T Lee
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Abstract

Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective study included 19 patients (median age, 65 years [range = 46-78 years]; 13 [68.4%] men and six [31.6%] women) with 29 retroperitoneal tumors treated over 22 MWA procedures. Hydrodissection (0.9% saline with 2% iohexol) was injected in 17 of 22 (77.3%) procedures to protect nontarget anatomy. The primary outcomes evaluated were local tumor progression (LTP) and complication rates. Oncologic outcomes, including overall survival (OS), progression-free survival (PFS), and treatment-free interval (TFI), were examined as secondary outcome measures. Results Median follow-up was 18 months (range = 0.5-113). Hydrodissection was successful in displacing nontarget anatomy in 16 of 17 (94.1%) procedures. The LTP rate was 3.4% (one of 29; 95% CI: 0.1, 17.8) per tumor and 5.3% (one of 19; 95% CI: 0.1, 26.0) per patient. The overall complication rate per patient was 15.8% (three of 19), including two minor complications and one major complication. The OS rate at 1, 2, and 3 years was 81.8%, 81.8%, and 72.7%, respectively, with a median OS estimated at greater than 7 years. There was no evidence of a difference in OS (P = .34) and PFS (P = .56) between patients with renal cell carcinoma (six of 19 [31.6%]) versus other tumors (13 of 19 [68.4%]) and patients treated with no evidence of disease (15 of 22 [68.2%]) versus patients with residual tumors (seven of 22 [31.8%]). Median TFI was 18 months (range = 0.5-108). Conclusion Treatment of retroperitoneal tumors with MWA combined with hydrodissection provided high rates of local control, prolonged systemic therapy-free intervals, and few serious complications. Keywords: Ablation Techniques (ie, Radiofrequency, Thermal, Chemical), Retroperitoneum, Microwave Ablation, Hydrodissection © RSNA, 2024.

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治疗腹膜后肿瘤的经皮微波消融术
目的 确定腹膜后肿瘤的微波消融 (MWA) 是否能安全地提供较高的局部肿瘤控制率。材料和方法 这项回顾性研究纳入了 19 名患者(中位年龄 65 岁 [范围 = 46-78 岁];13 名 [68.4%] 男性和 6 名 [31.6%] 女性),他们患有 29 例腹膜后肿瘤,接受了 22 次微波消融术治疗。在 22 例手术中,有 17 例(77.3%)注射了水切割液(0.9% 生理盐水加 2% 碘海醇),以保护非目标解剖结构。评估的主要结果是局部肿瘤进展(LTP)和并发症发生率。肿瘤学结果,包括总生存期(OS)、无进展生存期(PFS)和无治疗间隔期(TFI),则作为次要结果进行评估。结果 中位随访时间为 18 个月(范围 = 0.5-113)。在 17 例手术中,有 16 例(94.1%)的水切割成功移除了非目标解剖结构。每个肿瘤的 LTP 率为 3.4%(29 例中有 1 例;95% CI:0.1, 17.8),每个患者的 LTP 率为 5.3%(19 例中有 1 例;95% CI:0.1, 26.0)。每位患者的总并发症发生率为 15.8%(19 例中有 3 例),包括 2 例轻微并发症和 1 例严重并发症。1年、2年和3年的OS率分别为81.8%、81.8%和72.7%,中位OS估计超过7年。没有证据表明,肾细胞癌患者(19 例中的 6 例 [31.6%])与其他肿瘤患者(19 例中的 13 例 [68.4%])、无疾病证据患者(22 例中的 15 例 [68.2%])与残留肿瘤患者(22 例中的 7 例 [31.8%])之间的 OS(P = .34)和 PFS(P = .56)存在差异。中位 TFI 为 18 个月(范围 = 0.5-108)。结论 采用MWA联合水动力切除术治疗腹膜后肿瘤,局部控制率高,无系统治疗间隔时间长,严重并发症少。关键词消融技术(即射频、热、化学)、腹膜后、微波消融、水切割 © RSNA, 2024.
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