A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis

PurposeMicrowave ablation (MWA) is a minimally invasive local treatment with demonstrated safety and efficacy, but its role in managing multiple primary lung cancer (MPLC) is not well-established. This study retrospectively evaluates the clinical effectiveness of MWA compared to video-assisted thora...

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Main Authors: Bangsheng Li, Shengguai Gao, Jie Mao, Zhenghong Yang, Ying Chen, Xi Wang, Yunchao Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1547048/full
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author Bangsheng Li
Bangsheng Li
Shengguai Gao
Jie Mao
Zhenghong Yang
Ying Chen
Ying Chen
Xi Wang
Yunchao Huang
Yunchao Huang
author_facet Bangsheng Li
Bangsheng Li
Shengguai Gao
Jie Mao
Zhenghong Yang
Ying Chen
Ying Chen
Xi Wang
Yunchao Huang
Yunchao Huang
author_sort Bangsheng Li
collection DOAJ
description PurposeMicrowave ablation (MWA) is a minimally invasive local treatment with demonstrated safety and efficacy, but its role in managing multiple primary lung cancer (MPLC) is not well-established. This study retrospectively evaluates the clinical effectiveness of MWA compared to video-assisted thoracoscopic surgery (VATS) in treating MPLC.Materials and methodsA retrospective analysis was conducted using data from patients with non-small cell lung cancer (NSCLC) treated at Peking University Cancer Hospital Yunnan Hospital between January 2021 and April 2024. All patients had undergone surgical resection for their first primary lung cancer (FPLC) and subsequently received either MWA or VATS for second primary lung cancer (SPLC). After 1:1 propensity score matching (PSM), 202 patients per group were included. Study endpoints included progression-free survival (PFS), overall survival (OS), complications, and pulmonary function changes.ResultsMedian follow-up was 24.47 months. Survival analysis revealed a statistically significant difference in PFS between MWA and VATS groups (HR = 2.74, 95% CI: 1.40–5.36, p = 0.006), while OS showed no difference (HR = 1.41, 95% CI: 0.45–4.36, p = 0.56). The incidence of grade ≥ II complications was significantly lower in the MWA group (p < 0.001). Pulmonary function tests indicated no significant changes in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1%, maximal voluntary ventilation (MVV), and diffusion capacity of the lung for carbon monoxide%(DLCO%) before and 1–3 month post MWA (p > 0.05).ConclusionsIn MPLC patients with stage IA SPLC, VATS demonstrates a greater clinical efficacy advantage in terms of local tumor control compared to MWA. Additionally, MWA provided significant advantages in reducing complication severity and preserving pulmonary function. These findings suggest that the therapeutic approach combining surgery with MWA represents a safe and effective option for MPLC.
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spelling doaj-art-0e294f0dff2840ef876b32f882c73fc62025-08-20T01:58:04ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-03-011210.3389/fsurg.2025.15470481547048A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysisBangsheng Li0Bangsheng Li1Shengguai Gao2Jie Mao3Zhenghong Yang4Ying Chen5Ying Chen6Xi Wang7Yunchao Huang8Yunchao Huang9Department of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Tumor Center, Northeast Yunnan Central Hospital, Zhaotong, Yunnan, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Tumor Center, Northeast Yunnan Central Hospital, Zhaotong, Yunnan, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Surgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, Kunming, ChinaDepartment of Thoracic Tumor Center, Northeast Yunnan Central Hospital, Zhaotong, Yunnan, ChinaPurposeMicrowave ablation (MWA) is a minimally invasive local treatment with demonstrated safety and efficacy, but its role in managing multiple primary lung cancer (MPLC) is not well-established. This study retrospectively evaluates the clinical effectiveness of MWA compared to video-assisted thoracoscopic surgery (VATS) in treating MPLC.Materials and methodsA retrospective analysis was conducted using data from patients with non-small cell lung cancer (NSCLC) treated at Peking University Cancer Hospital Yunnan Hospital between January 2021 and April 2024. All patients had undergone surgical resection for their first primary lung cancer (FPLC) and subsequently received either MWA or VATS for second primary lung cancer (SPLC). After 1:1 propensity score matching (PSM), 202 patients per group were included. Study endpoints included progression-free survival (PFS), overall survival (OS), complications, and pulmonary function changes.ResultsMedian follow-up was 24.47 months. Survival analysis revealed a statistically significant difference in PFS between MWA and VATS groups (HR = 2.74, 95% CI: 1.40–5.36, p = 0.006), while OS showed no difference (HR = 1.41, 95% CI: 0.45–4.36, p = 0.56). The incidence of grade ≥ II complications was significantly lower in the MWA group (p < 0.001). Pulmonary function tests indicated no significant changes in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1%, maximal voluntary ventilation (MVV), and diffusion capacity of the lung for carbon monoxide%(DLCO%) before and 1–3 month post MWA (p > 0.05).ConclusionsIn MPLC patients with stage IA SPLC, VATS demonstrates a greater clinical efficacy advantage in terms of local tumor control compared to MWA. Additionally, MWA provided significant advantages in reducing complication severity and preserving pulmonary function. These findings suggest that the therapeutic approach combining surgery with MWA represents a safe and effective option for MPLC.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1547048/fullmultiple primary lung cancervideo-assisted thoracoscopic surgerymicrowave ablationcomplicationpulmonary function
spellingShingle Bangsheng Li
Bangsheng Li
Shengguai Gao
Jie Mao
Zhenghong Yang
Ying Chen
Ying Chen
Xi Wang
Yunchao Huang
Yunchao Huang
A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
Frontiers in Surgery
multiple primary lung cancer
video-assisted thoracoscopic surgery
microwave ablation
complication
pulmonary function
title A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
title_full A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
title_fullStr A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
title_full_unstemmed A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
title_short A retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer: a propensity score matching analysis
title_sort retrospective study of microwave ablation and thoracoscopic surgery for multiple primary lung cancer a propensity score matching analysis
topic multiple primary lung cancer
video-assisted thoracoscopic surgery
microwave ablation
complication
pulmonary function
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1547048/full
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