Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates.

Abstract

OBJECTIVE:

Treatment options for patients with non-small cell lung cancer who are not surgical candidates or who refuse operation are limited. Radiofrequency ablation represents a potential less invasive option for these patients. Our initial experience with radiofrequency ablation for peripheral, primary non-small cell lung cancer is reported.

METHODS:

We treated 21 tumors in 18 patients. Median age was 75 (range 58-86) years. Cancer stages were I (n = 9), II (n = 2), III (n = 3), and IV (n = 4). Patients with stage IV disease included 3 with recurrence after previous lobectomies and 1 with a synchronous liver metastasis also treated with radiofrequency ablation. Median tumor diameter was 2.8 cm (range 1.2-4.5 cm). Radiofrequency ablation was delivered by minithoracotomy in 2 cases and by a computed tomography-guided percutaneous approach in 16 patients. Computed tomographic and positron emission tomographic scans were used to evaluate recurrence and radiographic response in ablated nodules.

RESULTS:

One postoperative death occurred from pneumonia after open radiofrequency ablation. Median hospital stay was 2.5 days. A chest tube or pigtail catheter was required in 7 patients (38.9%) for procedure-related pneumothoraces. At a median follow-up of 14 months, 15 patients (83.3%) were alive. Local progression occurred in 8 nodules (38.1%). Mean and median progression-free intervals were 16.8 and 18 months, respectively. For stage I cancers, mean progression-free interval was 17.6 months. Median progression-free interval was not reached.

CONCLUSION:

This study demonstrates the feasibility of radiofrequency ablation for small, peripheral non-small cell lung cancer tumors. Local control is comparable to, if not better than, that provided by radiotherapy. Radiofrequency ablation should continue to be evaluated by thoracic surgeons as a noninvasive therapy for the high-risk patient with non-small cell lung cancer.

• Authors: Hiran C Fernando, Alberto De Hoyos, Rodney J Landreneau, Sebastian Gilbert, William E Gooding, Percival O Buenaventura, Neil A Christie, Chandra Belani, James D Luketich
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 129 Issue 3 Pg. 639-44 (Mar 2005) ISSN: 0022-5223 [Print] United States
• PMID: 15746749 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung (pathology, surgery)
• Catheter Ablation
• Disease Progression
• Female
• Humans
• Lung Neoplasms (pathology, surgery)
• Male
• Middle Aged
• Pneumothorax (epidemiology)
• Postoperative Complications (epidemiology)