Radiofrequency ablation for treatment of medically inoperable stage I non-small cell lung cancer.
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.
Lanuti
Michael
M
Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Mlanuti@partners.org
Sharma
Amita
A
Digumarthy
Subba R
SR
Wright
Cameron D
CD
Donahue
Dean M
DM
Wain
John C
JC
Mathisen
Douglas J
DJ
Shepard
Jo-Anne O
JA
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D016896:Treatment Outcome