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A Systematic Review and Meta-analysis of Patient Survival and Disease Recurrence Following Percutaneous Ablation of Pulmonary Metastasis

CardioVascular and Interventional Radiology volume 45, pages 1102–1113 (2022)Cite this article

Abstract

Background

Pulmonary metastasectomy has been widely adopted in the treatment of metastatic disease. In recent years image guided ablation has seen increased use in the treatment of thoracic malignancies. The objective of this study was to evaluate oncological outcomes following percutaneous ablation (PA) of pulmonary metastasis.

Methods

A comprehensive search of the PubMed, MEDLINE and EMBASE databases from January 2000 to August 2021 was performed to identify studies evaluating patient survival following ablation of lung metastasis. Pooled outcomes have been presented with a random effects model to assess primary outcomes of overall survival, progression free survival and 1-year local control. Secondary outcomes included procedural mortality, major complications, and the incidence of pneumothorax.

Results

A total of 24 studies were identified. The pooled median overall survival was 5.13 [95% confidence interval (CI): 4.37–6.84] years, and the 1-, 3-, 5-year progression free survival rates were 53%, 26% and 20% respectively. The 1-year local control rate was 91% (95%CI: 86–95%). Periprocedural mortality was rare (0%; 95%CI: 0–1%), as were major complications excluding pneumothorax (1%; 95%CI: 1–2%). Pneumothorax developed in 44% of ablation sessions, although only half of these required chest tube placement. Most patients were able to be discharged day one post-procedurally.

Conclusion

PA demonstrates high overall, progression free and local tumour survival in patients with lung metastasis. Complications and mortality are also rare. Consideration of its use should be made in a tumour board meeting in conjunction with surgical and radiotherapy perspectives for targeted local control of metastases.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Western Hospital, Footscray, Melbourne, VIC, 3011, Australia

    Minhtuan Nguyenhuy, Stephen Barnett & Simon Knight

  2. Department of Surgery, Peninsula Health, Frankston, VIC, 3199, Australia

    Yifan Xu

  3. Department of Interventional Radiology, Monash Health, Clayton, VIC, 3168, Australia

    Julian Maingard & Simon Knight

  4. Department of Thoracic Surgery, Austin Health, Heidelberg, VIC, 3084, Australia

    Stephen Barnett

  5. Interventional Radiology Service, Northern Health Radiology, Epping, VIC, 3076, Australia

    Hong Kuan Kok

  6. Department of Interventional Radiology, Austin Health, Heidelberg, VIC, Australia

    Mark Brooks & Hamed Asadi

  7. Department of Vascular and Interventional Radiology, St Vincent’s Hospital, Fiztroy, VIC, 3065, Australia

    Ashu Jhamb

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  1. Minhtuan Nguyenhuy
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Correspondence to Minhtuan Nguyenhuy.

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Nguyenhuy, M., Xu, Y., Maingard, J. et al. A Systematic Review and Meta-analysis of Patient Survival and Disease Recurrence Following Percutaneous Ablation of Pulmonary Metastasis. Cardiovasc Intervent Radiol 45, 1102–1113 (2022). https://doi.org/10.1007/s00270-022-03116-z

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  • DOI: https://doi.org/10.1007/s00270-022-03116-z

Keywords

  • Embolization
  • Lung
  • Pulmonary
  • Ablation
  • Oncology