1913P - Five year results of transbronchial microwave ablation of lung malignancies with electromagnetic navigation guidance

Background

Transbronchial microwave lung ablation has been a novel local therapy for early lung cancers and lung oligometastases, especially in patients who have high surgical risks or suffer from multifocal lung tumours. This is a single institute retrospective review of the 5-year result of transbronchial microwave ablation using electromagnetic navigation bronchoscopy guidance in the hybrid operating room.

Methods

Between March 2019 and March 2024, 223 nodules in 145 patients were treated. Eligible lung nodules were either proven lung cancers, metastases, or radiologically suspicious. Safety and mid-term control rate of the technique were assessed.

Results

Mean maximal diameter of lung nodules was 11.8mm (range 6-29mm), and bronchus sign was positive in only 24.7% of them. Technical success rate was 100%, although 104 (46.6%) nodules required double ablation and 25 (11.2%) required triple or more ablation for adequate coverage. Mean minimal ablation margin was 6.3mm. Concomitant lung resection for other nodules was performed in 16 cases. Mean hospital stay was 1.56 days, 172 cases (77.1%) and 214 cases (95.9%) were discharged by post-ablation day 1 and 3 respectively. Complications included mild pain which did not require hospitalization (6.7%), pneumothorax requiring drainage (3.6%), hemoptysis (2.7%), post-ablation reaction (2.2%) and pleural effusion (1.8%). Mean follow up for all cases is 25.3 months. Thirteen cases of local ablation site recurrence (5.8%) have been identified, which were treated by re-ablation, stereotactic radiation therapy or surgery.

Conclusions

Transbronchial microwave ablation is a safe and novel ablative technique, and has encouraging mid-term local control rate.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Research Grants Council (RGC) University Grant Committee Hong Kong, no: 14119019.

Disclosure

R. Lau: Financial Interests, Personal, Advisory Board: Medtronic. C. Ng: Financial Interests, Institutional, Speaker, Consultant, Advisor: Johnson and Johnson, Medtronic, USA, Siemens Healthineer. All other authors have declared no conflicts of interest.