SIR 2024
Interventional Oncology
Daniel H. Kim, MD
Medical Student
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Lucia Chen, MS
Principal Statistician
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Ashley Lamba, n/a
Medical Student
Zucker School of Medicine at Hofstra/Northwell
Disclosure information not submitted.
Fereidoun Abtin, MD
Professor
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Scott Genshaft, MD
Associate Clinical Professor
UCLA Interventional Radiology
Disclosure information not submitted.
Matthew Quirk
Disclosure information not submitted.
Robert Suh, MD
Clinical Professor, Radiological Sciences
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
To evaluate the efficacy and safety of tract cautery for lung microwave ablation (MWA) through comparison of post-procedure adverse event rates.
Materials and Methods:
This IRB-approved, HIPAA compliant study involved patients who underwent percutaneous MWA for their lung malignancy between 2012 to 2021. All patient demographics, treatment history, tumor characteristics, ablation details were collected. The study cohort was divided into patients in whom tract cautery was conducted during antenna removal and patients in whom the antenna was simply removed without tract cautery. Post-procedural adverse events including immediate, enlarging, and delayed pneumothorax, pleural effusion, and interventions were recorded. Univariate and multivariate logistic regression models were used to compare differences in adverse event rates.
Results:
This study cohort was composed of 365 lung MWA sessions for 190 patients. Out of the 165 cautery subcohort, 47% had immediate PTX, 10% had enlarging PTX, 14% had pleural effusion, 1% had delayed PTX, and 9% needed interventions. Out of the 200 non-cautery subcohort, 43% had immediate PTX, 23% had enlarging PTX, 19% had pleural effusion, 8% had delayed PTX, and 19% needed interventions. Cautery subcohort had significantly reduced rates of enlarging PTX (p=0.025) and delayed PTX (p=0.019). Presence of emphysema, tumor size and location, and history of prior lung radiation therapy showed to be a significant predictor of adverse events and need for interventions (p< 0.05).
Conclusion:
Tract cauterization proves to reduce post-MWA enlarging and delayed PTX. Utilizing tract cauterization in lung MWA shows to be safe and effective in reducing adverse event rates for percutaneous lung MWA.