PMID- 36652940
OWN - NLM
STAT- MEDLINE
DCOM- 20230315
LR  - 20230403
IS  - 1423-0356 (Electronic)
IS  - 0025-7931 (Print)
IS  - 0025-7931 (Linking)
VI  - 102
IP  - 3
DP  - 2023
TI  - Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 
      Lung Cancer.
PG  - 182-193
LID - 10.1159/000528820 [doi]
AB  - BACKGROUND: Image-guided percutaneous thermal ablation is an established 
      treatment option for early-stage lung cancer in medically inoperable patients but 
      carries a high risk of pleura-related complications, particularly pneumothorax. 
      OBJECTIVE: This study aimed to determine if image-guided transbronchial microwave 
      ablation (tMWA) is a feasible approach to treat peripheral stage 1 lung cancer. 
      METHOD: A prospective, single-arm, multicenter study sought to enroll 40 adults 
      who were medically inoperable or declined surgery for peripheral stage 1 lung 
      tumors (</=20 mm). Ablation was performed using navigational bronchoscopy and a 
      flexible MWA probe, guided by cone-beam CT with augmented fluoroscopy. Follow-up 
      at 1, 6, and 12 months included CT imaging of the ablation zone and possible 
      tumor recurrence, adverse events (AEs), pulmonary function, and quality of life. 
      RESULTS: Across 2 sites, 11 tumors (10 NSCLC, 1 carcinoid) were treated in 10 
      enrolled patients. Median tumor diameter was 13 x 14 mm (7-19 mm) and median 
      minimum ablative margin was 11 mm (5-19 mm). Technical success and technique 
      efficacy were achieved in all patients. No tumor recurrence was seen during 
      12-month follow-up. No pneumothorax, pleural effusion, or bronchopleural fistula 
      were noted. Minor AEs included scant hemoptysis, pain, cough, and dyspnea. Two 
      serious AEs occurred </=30 days of ablation and included a COPD exacerbation (day 
      9) and a death of unknown cause (day 15). The death led the sponsor to halt 
      enrollment. Pulmonary function and quality-of-life indices remained stable. 
      CONCLUSIONS: Image-guided tMWA is a technically feasible approach for peripheral 
      early-stage lung cancer but warrants further evaluation of safety and efficacy in 
      larger cohorts.
CI  - (c) 2023 The Author(s). Published by S. Karger AG, Basel.
FAU - Pritchett, Michael A
AU  - Pritchett MA
AD  - Department of Pulmonary Medicine, FirstHealth of the Carolinas & Pinehurst 
      Medical Clinic, Pinehurst, North Carolina, USA.
FAU - Reisenauer, Janani S
AU  - Reisenauer JS
AD  - Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, 
      Minnesota, USA.
AD  - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo 
      Clinic, Rochester, Minnesota, USA.
FAU - Kern, Ryan
AU  - Kern R
AD  - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo 
      Clinic, Rochester, Minnesota, USA.
FAU - Wilson, David S
AU  - Wilson DS
AD  - Department of Pulmonology, Schneck Medical Center, Seymour, Indiana, USA.
FAU - Meyers, Erin E
AU  - Meyers EE
AD  - Ethicon, Inc., Johnson & Johnson, Raritan, New Jersey, USA, eprifog1@its.jnj.com.
FAU - Szapary, Philippe O
AU  - Szapary PO
AD  - Lung Cancer Initiative, Johnson & Johnson Enterprise Innovation, New Brunswick, 
      New Jersey, USA.
FAU - Laeseke, Paul F
AU  - Laeseke PF
AD  - Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230118
PL  - Switzerland
TA  - Respiration
JT  - Respiration; international review of thoracic diseases
JID - 0137356
SB  - IM
MH  - Adult
MH  - Humans
MH  - Microwaves/therapeutic use
MH  - Prospective Studies
MH  - Quality of Life
MH  - *Catheter Ablation/adverse effects
MH  - Neoplasm Recurrence, Local/etiology/pathology/surgery
MH  - *Lung Neoplasms/pathology
MH  - *Pneumothorax/etiology/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC10064382
OTO - NOTNLM
OT  - Augmented fluoroscopy
OT  - Cone-beam computed tomography
OT  - Electromagnetic navigation bronchoscopy
OT  - Lung cancer
OT  - Microwave ablation
COIS- Michael Pritchett reports personal fees from Medtronic, BodyVision, Intuitive 
      Surgical, Philips, Biodesix, AstraZeneca, Johnson & Johnson, Noah Medical, United 
      Therapeutics, Actelion, Pfizer, Ambu, and Boston Scientific. Janani Reisenauer 
      receives funding for a research grant sponsored by Intuitive Surgical and 
      consults for Vergent, Elucent Medical, Noah Medical, and AstraZeneca. Ryan Kern 
      is member of the scientific advisory board at VisionAir Solutions. David Wilson 
      is a consultant at Johnson & Johnson and reports consultancy fees from Vergent, 
      Boston Scientific, HeptaMed, Preora, Phillips, AstraZeneca, Auris Health, 
      Pinnacle Biologics, VIDA Diagnostics, Galil Medical, CSA Inc., and Glaxo Smith 
      Kline. Philippe Szapary and Erin Meyers are full-time employees of Johnson & 
      Johnson. Paul Laeseke is a consultant at Johnson & Johnson; shareholder, 
      consultant, and holder of a sponsored research agreement with HistoSonics; 
      shareholder and consultant at Elucent Medical; shareholder at McGinley Orthopedic 
      Innovations; and holder of a sponsored research agreement with Siemens.
EDAT- 2023/01/19 06:00
MHDA- 2023/03/16 06:00
PMCR- 2023/01/18
CRDT- 2023/01/18 18:23
PHST- 2022/03/16 00:00 [received]
PHST- 2022/10/08 00:00 [accepted]
PHST- 2023/01/19 06:00 [pubmed]
PHST- 2023/03/16 06:00 [medline]
PHST- 2023/01/18 18:23 [entrez]
PHST- 2023/01/18 00:00 [pmc-release]
AID - 000528820 [pii]
AID - res-0102-0182 [pii]
AID - 10.1159/000528820 [doi]
PST - ppublish
SO  - Respiration. 2023;102(3):182-193. doi: 10.1159/000528820. Epub 2023 Jan 18.