Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients.
OBJECTIVE
To evaluate retrospectively the long-term survival of patients with early-stage non-small cell lung cancer (NSCLC) treated with cryoablation.


METHODS
Cryoablation was performed on 47 T1N0M0 NSCLCs in 45 consecutive patients between 2006 and January 2011. All ablative procedures were performed with 16-gauge or 13-gauge cryoprobes. The number of probes used was determined by the size and geometry of the tumor. Local and regional recurrence rates were monitored. Complications were assessed by the Society of Interventional Radiology (SIR) classification system.


RESULTS
The 5-year survival rate was 67.8% ± 15.3, the cancer-specific survival rate at 5 years was 56.6% ± 16.5, and the 5-year progression-free survival rate was 87.9% ± 9. The probe per unit tumor diameter was 1.4 probes/cm. In eight patients, 16-gauge cryoprobes were used. Two cases were performed with a single needle. The remaining cases were performed with 13-gauge cryoprobes except for one case in which both probe sizes were used. The combined local and regional recurrence rate was 36.2%. Major complications occurred in 6.4% of patients, including two cases of hemoptysis and a prolonged placement of a chest tube requiring mechanical sclerosis in one patient. There were no deaths in the first 30 days after treatment.


CONCLUSIONS
Cryoablation is associated with a good overall long-term survival with minimally significant complications. Cryoablation is a potentially curative, viable therapeutic option for patients with stage I NSCLC who are deemed medically inoperable.
Department of Radiology, State University of New York at Stony Brook, University Hospital, HSC level IV Room 120, Stony Brook, NY 11794. Electronic address: William.Moore@stonybrook.edu.
William
W
Moore
Department of Radiology, State University of New York at Stony Brook, University Hospital, HSC level IV Room 120, Stony Brook, NY 11794.
Ronak
R
Talati
Department of Radiology, State University of New York at Stony Brook, University Hospital, HSC level IV Room 120, Stony Brook, NY 11794.
Priya
P
Bhattacharji
Department of Surgery, State University of New York at Stony Brook, University Hospital, HSC level IV Room 120, Stony Brook, NY 11794.
Thomas
T
Bilfinger
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003452:Cryosurgery / Q000401:mortality* / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging; D009518:New York / Q000453:epidemiology; D011013:Pneumonectomy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome