Radiofrequency ablation for treatment of medically inoperable stage I non-small cell lung cancer

J Thorac Cardiovasc Surg. 2009 Jan;137(1):160-6. doi: 10.1016/j.jtcvs.2008.08.034. Epub 2008 Oct 30.


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.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Catheter Ablation*
  • Female
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Neoplasm Staging
  • Treatment Outcome