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Radiofrequency and microwave ablation for treatment of recurrent gynecologic malignancies
  1. Naixin Zhang1,
  2. Catherine Coffman1,
  3. Ben Wilson2,
  4. Joann Gold1,
  5. Scott Baum3,
  6. Todd Tillmanns2 and
  7. Adam ElNaggar2
  1. 1Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
  2. 2Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA
  3. 3Interventional Radiology, West Cancer Center, Memphis, Tennessee, USA
  1. Correspondence to Dr Adam ElNaggar, Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA; acelnaggar{at}gmail.com

Abstract

Objective Radiofrequency ablation and microwave ablation are used to vaporize tumors not amenable to surgical resection. We sought to evaluate the safety and efficacy of radiofrequency and microwave ablation for the treatment of isolated lesions in patients with recurrent gynecologic malignancy.

Methods Patients with gynecologic malignancies treated with radiofrequency or microwave ablation at a university-affiliated cancer center from April 2007 to January 2020 were evaluated. Clinical records were reviewed for number of prior chemotherapy regimens, response to ablation, time to progression, and location of progression.

Results Thirty-two patients received ablative therapy for treatment of isolated recurrences. Seventeen (53%) patients had ovarian cancer, seven (22%) had endometrial cancer, and eight (25%) had cervical cancer. Thirteen (41%) patients received radiofrequency ablation and 19 (59%) received microwave ablation. Patients had a median of 2 (range 1–12) prior lines of chemotherapy. Sixteen (50%) patients achieved a partial or complete response with two patients experiencing no progression at time of submission. Six (19%) patients had stable disease and 10 (31%) patients had progression at time of initial follow-up imaging. Median progression-free survival for the cohort was 7.3 months (range 1.4–64.7). No significant improvement in median progression-free survival was seen with the addition of adjuvant systemic therapy to radiofrequency or microwave ablation (6.9 vs 7.7 months; HR 0.7, 95% CI 0.3 to 1.7). Clinical benefit, defined as absence of definitive progression at the site of ablation or new target lesions at 4 months, was seen in 22 (68.8%) patients. No major complications occurred, with two patients reporting pain or weakness at the site of ablation.

Conclusion Radiofrequency and microwave ablation demonstrated that 68.8% (n=22) of patients experienced clinical benefit at 4 months. Ablative therapy may be considered for the treatment of isolated lesions in patients with recurrent gynecologic malignancies.

  • Radiology, Interventional
  • Neoplasm Recurrence, Local
  • Carcinoma
  • Radiotherapy, Image-Guided

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors All authors have provided substantial contributions and are in agreement with all aspects of the final manuscript. NZ: Data curation, formal analysis, writing – review and editing. CC: Data curation, writing – original draft. BW: writing – review and editing. JG: Data curation, writing – review and editing. SB: Software, methodology, visualization. TT: Conceptualization, methodology, supervision, writing – original draft/review and editing. AE: Guarantor, conceptualization, methodology, supervision, writing – original draft/review and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AE reports non-financial support from Caris Life Sciences, AstraZeneca, and Tesaro/GSK, as well as consulting fees from AstraZeneca, AbbVie, Merck, Leap Therapeutics, and Clovis Oncology during the conduct of the study. TT receives personal fees from AstraZeneca and Johnson and Johnson. No disclosures from other authors. All fees are outside of submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.