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.