Exploring the impact of variable power outputs on the efficacy and safety during microwave ablation for lung carcinoma: a real-world study

Abstract

Background: Microwave ablation (MWA) is an important method for the treatment of lung cancer, but there is still a lack of standard guidelines for the selection of power. This study aimed to explore the effectiveness and safety of MWA at different power levels.

Methods: The study gathered individuals underwent MWA for lung cancer between January 2012 and December 2020. All patients were divided into low power group and high power group based on the power of MWA. By intergroup comparisons, we clarified the differences between the two groups.

Results: In this study, 265 participants were involved, with 192 in the low power group and 73 in the high power group. Compared to the low power group, the high power group had a significantly higher incidence of postoperative complications (63.0% vs. 24.0%). In the Kaplan-Meier analysis, overall survival (OS) and disease-free survival (DFS) of the high power group were both better than the low power group. We found through Cox regression analysis that smoking, tumor volume, tumor differentiation, gene mutation, neutrophil count, and lymphocyte count were independent factors affecting the OS of patients. Based on the above factors, we constructed a nomogram, with areas under the curve (AUCs) of 0.941, 0.903, and 0.905 for predicting 1-, 2-, and 3-year OS after MWA, respectively.

Conclusions: While high-power MWA brings better long-term prognosis to patients, it also leads to an increase in postoperative complications. The application of a nomogram for stratifying the prognosis of patients may be a more feasible approach to further develop individualized treatment plans.

Keywords: Lung carcinoma; complication; microwave ablation (MWA); power; prognosis.

Figure 1

Kaplan-Meier curves for long-term prognosis analysis of low power group and high power group. (A) Kaplan-Meier survival curves for assessing overall survival of low power group and high power group. (B) Kaplan-Meier survival curves for assessing disease-free survival of low power group and high power group. OS, overall survival; MWA, microwave ablation; DFS, disease-free survival.

Figure 2

Nomogram of predicted overall survival of lung cancer patients undergoing MWA. MWA, microwave ablation.

Figure 3

ROC curves of the nomogram for lung cancer patients undergoing MWA for 1-, 2-, and 3-year overall survival. ROC, receiver operating characteristic; AUC, area under ROC curve; MWA, microwave ablation.