Radiofrequency and microwave ablation for treatment of recurrent gynecologic malignancies

Naixin Zhang; Catherine Coffman; Ben Wilson; Joann Gold; Scott Baum; Todd Tillmanns; Adam ElNaggar

doi:10.1136/ijgc-2022-003444

Radiofrequency and microwave ablation for treatment of recurrent gynecologic malignancies

Int J Gynecol Cancer. 2022 Jun 9:ijgc-2022-003444. doi: 10.1136/ijgc-2022-003444. Online ahead of print.

Authors

Naixin Zhang¹, Catherine Coffman¹, Ben Wilson², Joann Gold¹, Scott Baum³, Todd Tillmanns², Adam ElNaggar⁴

Affiliations

¹ Obstetrics and Gynecology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
² Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA.
³ Interventional Radiology, West Cancer Center, Memphis, Tennessee, USA.
⁴ Gynecologic Oncology, West Cancer Center, Memphis, Tennessee, USA acelnaggar@gmail.com.

PMID: 35680136
DOI: 10.1136/ijgc-2022-003444

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.

Keywords: Carcinoma; Neoplasm Recurrence, Local; Radiology, Interventional; Radiotherapy, Image-Guided.