Evolving technology
Radiofrequency ablation for treatment of medically inoperable stage I non–small cell lung cancer

https://doi.org/10.1016/j.jtcvs.2008.08.034Get rights and content
Under an Elsevier user license
open archive

Objective

This study evaluated long-term results of radiofrequency ablation for medically inoperable early–stage lung cancer.

Methods

Thirty-one consecutive patients with biopsy-proven non–small cell lung cancer underwent 38 treatments of computed tomographically guided radiofrequency ablation in a 4.5-year period. All patients were carefully selected and deemed medically ineligible for resection by a multidisciplinary team. Radiofrequency ablation was performed with curative intent with a single or cluster cool-tip electrode. Patients were hospitalized for 23-hour observation.

Results

Treatment was complete in all cases, with no 30-day mortality. Local recurrence was confirmed radiographically by computed tomography, positron emission tomography, or both after 31.5% of treatments (12/38). Two patients were successfully retreated for technical failures related to pneumothorax; 3 underwent radiotherapy with stable disease. Mean maximal diameter of 38 tumors treated was 2.0 ± 1.0 cm (range 0.8–4.4 cm). After median follow-up of 17 ± 11 months, 74% of patients (23/31) were alive. Three patients died of metastatic disease; 5 died of pneumonia remote from treatment. The 2- and 4-year survivals were 78% and 47%, respectively. Median overall survival was 30 months. Pneumothorax (13%), pneumonia (16%), and pleural effusion (21%), were the most common complications.

Conclusions

Radiofrequency ablation of medically inoperable early–stage lung cancer in carefully selected patients yields encouraging midterm results without significant loss of pulmonary function. Local tumor progression appears related to lung tumors larger than 3 cm. Computed tomography and positron emission tomography need further validation for the early identification of local tumor progression following radiofrequency ablation.

Abbreviations and Acronyms

CT
computed tomography
NSCLC
non–small cell lung cancer
PET
positron emission tomography
RFA
radiofrequency ablation
XRT
external beam radiotherapy

CTSNet classification

10

Cited by (0)

Read at the Eighty-eighth Annual Meeting of The American Association for Thoracic Surgery, San Diego, Calif, May 10–14, 2008.