Percutaneous radiofrequency ablation for clinical stage I non-small cell lung cancer: results in 20 nonsurgical candidates.
OBJECTIVE
Our objective was to evaluate the outcomes of radiofrequency ablation for nonsurgical candidates with clinical stage I non-small cell lung cancer.


METHODS
This study was carried out on 20 nonsurgical candidates (11 men and 9 women; mean age, 75.6 years) with clinical stage I (IA, n = 14; IB, n = 6) non-small cell lung cancer. All patients were deemed nonsurgical candidates because of poor pulmonary function (n = 7), poor cardiac function (n = 3), poor performance status (n = 4), or refusal to undergo surgery (n = 6). The mean long-axis tumor diameter was 2.4 cm. Twenty patients underwent 23 percutaneous ablation sessions, including 3 repeat sessions for the treatment of local progression. The outcomes of radiofrequency ablation were retrospectively evaluated.


RESULTS
Procedural complications included pneumothorax (n = 13 [57%]) and pleural effusion (n = 4 [17%]). One case of pneumothorax required chest tube placement. The median follow-up period was 21.8 months. Local progression was observed in 7 (35%) patients a median of 9.0 months after the first session. The local control rates were 72% at 1 year, 63% at 2 years, and 63% at 3 years. The mean survival time was 42 months. The overall survivals and cancer-specific survivals were 90% and 100% at 1 year, 84% and 93% at 2 years, and 74% and 83% at 3 years, respectively.


CONCLUSIONS
Treating clinical stage I non-small cell lung cancer with one or more radiofrequency ablation sessions provided promising outcomes in terms of survival, although the rate of local progression was relatively high. A prospective study with a larger population and longer follow-up is warranted.
Hiraki
Takao
T
Department of Radiology, Okayama University Medical School, Okayama, Japan. takaoh@tc4.so-net.ne.jp
Gobara
Hideo
H
Iishi
Tatsuhiko
T
Sano
Yoshifumi
Y
Iguchi
Toshihiro
T
Fujiwara
Hiroyasu
H
Tajiri
Nobuhisa
N
Sakurai
Jun
J
Date
Hiroshi
H
Mimura
Hidefumi
H
Kanazawa
Susumu
S
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D017115:Catheter Ablation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome