Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors
Abstract Objectives To compare the incidence of persistent air leak (PAL) following cryoablation vs MWA of lung tumors when the ablation zone includes the pleura. Methods This bi-insti...
| Main Authors: | , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | English |
| Published: |
Springer Berlin Heidelberg
2023
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| Online Access: | https://hdl.handle.net/1721.1/151071 |
| _version_ | 1826198154594222080 |
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| author | Abrishami Kashani, Maya Murphy, Mark C. Saenger, Jonathan A. Wrobel, Maria M. Tahir, Ismail Mrah, Sofiane Ringer, Stefan Bunck, Alexander C. Silverman, Stuart G. Shyn, Paul B. Pachamanova, Dessislava A. Fintelmann, Florian J. |
| author2 | Sloan School of Management |
| author_facet | Sloan School of Management Abrishami Kashani, Maya Murphy, Mark C. Saenger, Jonathan A. Wrobel, Maria M. Tahir, Ismail Mrah, Sofiane Ringer, Stefan Bunck, Alexander C. Silverman, Stuart G. Shyn, Paul B. Pachamanova, Dessislava A. Fintelmann, Florian J. |
| author_sort | Abrishami Kashani, Maya |
| collection | MIT |
| description | Abstract
Objectives
To compare the incidence of persistent air leak (PAL) following cryoablation vs MWA of lung tumors when the ablation zone includes the pleura.
Methods
This bi-institutional retrospective cohort study evaluated consecutive peripheral lung tumors treated with cryoablation or MWA from 2006 to 2021. PAL was defined as an air leak for more than 24 h after chest tube placement or an enlarging postprocedural pneumothorax requiring chest tube placement. The pleural area included by the ablation zone was quantified on CT using semi-automated segmentation. PAL incidence was compared between ablation modalities and a parsimonious multivariable model was developed to assess the odds of PAL using generalized estimating equations and purposeful selection of predefined covariates. Time-to-local tumor progression (LTP) was compared between ablation modalities using Fine-Gray models, with death as a competing risk.
Results
In total, 260 tumors (mean diameter, 13.1 mm ± 7.4; mean distance to pleura, 3.6 mm ± 5.2) in 116 patients (mean age, 61.1 years ± 15.3; 60 women) and 173 sessions (112 cryoablations, 61 MWA) were included. PAL occurred after 25/173 (15%) sessions. The incidence was significantly lower following cryoablation compared to MWA (10 [9%] vs 15 [25%]; p = .006). The odds of PAL adjusted for the number of treated tumors per session were 67% lower following cryoablation (odds ratio = 0.33 [95% CI, 0.14–0.82]; p = .02) vs MWA. There was no significant difference in time-to-LTP between ablation modalities (p = .36).
Conclusions
Cryoablation of peripheral lung tumors bears a lower risk of PAL compared to MWA when the ablation zone includes the pleura, without adversely affecting time-to-LTP.
Key Points
• The incidence of persistent air leaks after percutaneous ablation of peripheral lung tumors was lower following cryoablation compared to microwave ablation (9% vs 25%; p = .006).
• The mean chest tube dwell time was 54% shorter following cryoablation compared to MWA (p = .04).
• Local tumor progression did not differ between lung tumors treated with percutaneous cryoablation compared to microwave ablation (p = .36). |
| first_indexed | 2024-09-23T10:59:52Z |
| format | Article |
| id | mit-1721.1/151071 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T10:59:52Z |
| publishDate | 2023 |
| publisher | Springer Berlin Heidelberg |
| record_format | dspace |
| spelling | mit-1721.1/1510712024-03-21T06:45:03Z Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors Abrishami Kashani, Maya Murphy, Mark C. Saenger, Jonathan A. Wrobel, Maria M. Tahir, Ismail Mrah, Sofiane Ringer, Stefan Bunck, Alexander C. Silverman, Stuart G. Shyn, Paul B. Pachamanova, Dessislava A. Fintelmann, Florian J. Sloan School of Management Abstract Objectives To compare the incidence of persistent air leak (PAL) following cryoablation vs MWA of lung tumors when the ablation zone includes the pleura. Methods This bi-institutional retrospective cohort study evaluated consecutive peripheral lung tumors treated with cryoablation or MWA from 2006 to 2021. PAL was defined as an air leak for more than 24 h after chest tube placement or an enlarging postprocedural pneumothorax requiring chest tube placement. The pleural area included by the ablation zone was quantified on CT using semi-automated segmentation. PAL incidence was compared between ablation modalities and a parsimonious multivariable model was developed to assess the odds of PAL using generalized estimating equations and purposeful selection of predefined covariates. Time-to-local tumor progression (LTP) was compared between ablation modalities using Fine-Gray models, with death as a competing risk. Results In total, 260 tumors (mean diameter, 13.1 mm ± 7.4; mean distance to pleura, 3.6 mm ± 5.2) in 116 patients (mean age, 61.1 years ± 15.3; 60 women) and 173 sessions (112 cryoablations, 61 MWA) were included. PAL occurred after 25/173 (15%) sessions. The incidence was significantly lower following cryoablation compared to MWA (10 [9%] vs 15 [25%]; p = .006). The odds of PAL adjusted for the number of treated tumors per session were 67% lower following cryoablation (odds ratio = 0.33 [95% CI, 0.14–0.82]; p = .02) vs MWA. There was no significant difference in time-to-LTP between ablation modalities (p = .36). Conclusions Cryoablation of peripheral lung tumors bears a lower risk of PAL compared to MWA when the ablation zone includes the pleura, without adversely affecting time-to-LTP. Key Points • The incidence of persistent air leaks after percutaneous ablation of peripheral lung tumors was lower following cryoablation compared to microwave ablation (9% vs 25%; p = .006). • The mean chest tube dwell time was 54% shorter following cryoablation compared to MWA (p = .04). • Local tumor progression did not differ between lung tumors treated with percutaneous cryoablation compared to microwave ablation (p = .36). 2023-07-10T18:54:04Z 2023-07-10T18:54:04Z 2023-03-09 2023-07-07T03:28:20Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/151071 Abrishami Kashani, Maya, Murphy, Mark C., Saenger, Jonathan A., Wrobel, Maria M., Tahir, Ismail et al. 2023. "Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors." en https://doi.org/10.1007/s00330-023-09499-y Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. The Author(s), under exclusive licence to European Society of Radiology application/pdf Springer Berlin Heidelberg Springer Berlin Heidelberg |
| spellingShingle | Abrishami Kashani, Maya Murphy, Mark C. Saenger, Jonathan A. Wrobel, Maria M. Tahir, Ismail Mrah, Sofiane Ringer, Stefan Bunck, Alexander C. Silverman, Stuart G. Shyn, Paul B. Pachamanova, Dessislava A. Fintelmann, Florian J. Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title | Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title_full | Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title_fullStr | Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title_full_unstemmed | Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title_short | Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| title_sort | risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors |
| url | https://hdl.handle.net/1721.1/151071 |
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