Surgical Outcomes of Video-Assisted Thoracic Surgery Combined With Computed Tomography-Guided Microwave Ablation for Lung Cancer Presenting as Multiple Ground-Glass Opacities: A 5-Year Retrospective Cohort Study.

IF 2.3 3区 医学 Q3 ONCOLOGY
Bin Huang, Chuanfei Zhan, Pengcheng Yu, Yifan Xu, Muhammad Zunair Bhatti, TianMing Chen, WenDa Yin, Zhifei Ma, Chi Su, Zhongqiu Wang, Dongjie Feng, Tian Shen, Xiaokang Shen, Dongqing Lu, Lin Zheng, Shilin Chen
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引用次数: 0

Abstract

Background: Multiple ground glass opacities (mGGOs) are frequently observed in patients with early-stage lung adenocarcinoma. The most appropriate and effective treatment for these mGGOs remains controversial. The purpose of this study was to retrospectively review the usefulness and safety of performing video-assisted thoracic surgery (VATS) combined with computed tomography (CT)-guided microwave ablation (MWA) in patients with synchronous multiple primary lung cancer (sMPLC) and to demonstrate the long-term surgical outcomes at our institute.

Materials and methods: From April 2019 to December 2021, we enrolled 47 patients who underwent VATS combined with CT-guided MWA for mGGOs. Comprehensive data regarding the enrolled subjects, including clinical features, imaging findings, histopathological characteristics, and surgical records, were meticulously extracted from the surgical database and electronic medical records. The outcomes assessed in this study included the feasibility and safety profile of the combined procedure, as well as event-free survival (EFS), local progression-free survival (LPFS), and overall survival (OS).

Results: A total of 47 patients with sMPLC characterized by mGGOs underwent VATS combined with CT-guided MWA. In this cohort, 173 GGOs were removed, including 69 nodules (39.9%) larger than 8 mm and 104 nodules (60.1%) measuring between 5 and 8 mm. We recorded all 58 types of VATS surgeries performed on 83 nodules. Additionally, 90 secondary nodules were treated with CT-guided MWA during either a single hospitalization or multiple hospitalizations (ranging from 1 to 4). We achieved a 100% technical success rate among the 47 patients. During the follow-up, there was no local tumor progression or recurrence among the 47 patients. Event-free survival was 100% at 3 years and 66.82% at 5 years, and the 5-year overall survival rate was 97.5%, with only one patient dying from an unrelated cause.

Conclusion: VATS combined with CT-guided MWA is a safe and effective method for patients with mGGOs. This combination marks the onset of an era where surgeons can utilize both a needle and a scalpel simultaneously.

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一项5年回顾性队列研究:视频辅助胸外科联合计算机断层扫描引导微波消融治疗以多发毛玻璃混浊为表现的肺癌的手术效果。
背景:多发磨玻璃混浊(mGGOs)常见于早期肺腺癌患者。对于这些mggo最适当和有效的治疗方法仍然存在争议。本研究的目的是回顾性评价视频辅助胸外科手术(VATS)联合计算机断层扫描(CT)引导微波消融(MWA)治疗同步多发原发性肺癌(sMPLC)的有效性和安全性,并证明我院的长期手术效果。材料和方法:2019年4月至2021年12月,我们招募了47例接受VATS联合ct引导下MWA治疗mGGOs的患者。从外科数据库和电子病历中精心提取有关入选受试者的综合数据,包括临床特征、影像学表现、组织病理学特征和手术记录。本研究评估的结果包括联合治疗的可行性和安全性,以及无事件生存期(EFS)、局部无进展生存期(LPFS)和总生存期(OS)。结果:共有47例以mGGOs为特征的sMPLC患者行VATS联合ct引导MWA。在该队列中,173个ggo被切除,其中69个(39.9%)结节大于8 mm, 104个(60.1%)结节在5 - 8 mm之间。我们记录了83个结节的58种VATS手术。此外,90例继发性结节在单次住院或多次住院期间(从1到4次)接受ct引导下的MWA治疗。我们在47例患者中取得了100%的技术成功率。随访期间,47例患者无局部肿瘤进展或复发。3年无事件生存率为100%,5年生存率为66.82%,5年总生存率为97.5%,仅有1例患者死于非相关原因。结论:VATS联合ct引导下MWA治疗mggo是一种安全有效的方法。这种结合标志着外科医生可以同时使用针和手术刀的时代的开始。
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来源期刊
Thoracic Cancer
Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM
CiteScore
5.20
自引率
3.40%
发文量
439
审稿时长
2 months
期刊介绍: Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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