According to a new study in the American Journal of Roentgenology (AJR), percutaneous image-guided microwave and cryoablation allow for repeat minimally invasive treatment of sarcoma lung metastases with manageable, predominantly mild complications.

“High primary technical success, local control, and overall survival support microwave and cryoablation for treating sarcoma lung metastases,” concludes 2019 ARRS Scholar Florian J. Fintelmann, MD, a radiologist at the Boston-based Massachusetts General Hospital and Harvard Medical School. Noting that ablation modality and tumor location did not affect local progression (p>.05), “treatment failure was low, especially for small tumors,” Fintelmann says

Fintelmann and colleagues’ retrospective cohort study included 27 patients (16 women, 11 men; median age, 64 years; Eastern Cooperative Oncology Group performance score, 0–2) who underwent 39 percutaneous CT-guided ablation sessions (21 microwave, 18 cryoablation; 1–4 sessions per patient) to treat 65 sarcoma lung metastases (median 1 tumor per patient, range 1-12; median tumor diameter 11 mm, range 5-33 mm; 25% non-peripheral) from 2009 to 2021.  

Estimated two-year local control rate for microwave versus cryoablation was 95% and 98% for tumors ≤1 cm, and 62% and 79% for tumors >1 cm. Additionally, tumor size ≤1 cm was associated with decreased cumulative incidence of local progression (p=.048).

Reiterating the suitability of both percutaneous microwave and cryoablation for treating tumors ≤1 cm, whether peripheral or non-peripheral, “complications, if they occur, are not life-threatening,” the authors of this AJR article add.