title: Wedge resection and radiofrequency ablation for stage I nonsmall cell lung cancer.
abstract: The main aim of this study was to compare radiofrequency ablation (RFA) and wedge resection in terms of disease recurrence and survival, as intent-to-treat therapy for stage I nonsmall cell lung cancer (NSCLC) in marginal or non-surgical candidates. 121 high-risk patients, treated for stage I NSCLC with wedge resection (n=59) or RFA (n=62) in a 7-year period, were analysed. Age, sex, comorbidity score, performance status, forced expiratory volume in 1 s and forced vital capacity values, body mass index, T-stage and histology were evaluated as possible risk factors affecting disease recurrence and survival. At a median follow-up of 36 and 42 months for wedge resection and for RFA (p=0.232), local recurrence rate was 2 and 23%, respectively (p=0.002). The 1-, 2- and 5-year overall survival (disease-free interval) rates were 100% (96%), 96% (90%) and 52% (76%) for wedge resection, and 93% (87%), 72% (63%), and 35% (55%) for RFA (p=0.044 and p=0.01, respectively). None of the analysed parameters was found to be risk factor for disease recurrence and survival, except stage T2, which significantly affected disease-recurrence, overall and cancer-related survival and disease-free interval in the RFA group. Whenever possible, surgical resection, even if limited, should be preferred due to its higher disease control and survival rates. RFA can be considered a valid option for inoperable patients, especially for those with stage T1N0.
authors.affiliation: Division of Thoracic Surgery, Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors.forename: Marcello C
authors.initials: MC
authors.lastname: Ambrogi
authors.affiliation: Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, Cisanello University Hospital, Pisa, Italy olivia.fanucchi@for.unipi.it.
authors.forename: Olivia
authors.initials: O
authors.lastname: Fanucchi
authors.affiliation: Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, Cisanello University Hospital, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Dini
authors.affiliation: Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, Cisanello University Hospital, Pisa, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Melfi
authors.affiliation: Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, Cisanello University Hospital, Pisa, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Davini
authors.affiliation: Division of Thoracic Surgery, Cardiac Thoracic and Vascular Department, Cisanello University Hospital, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lucchi
authors.affiliation: Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Massimetti
authors.affiliation: Division of Thoracic Surgery, Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mussi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome