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J Thorac Cardiovasc Surg 2007;134:1306-1312
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Percutaneous radiofrequency ablation for clinical stage I non–small cell lung cancer: Results in 20 nonsurgical candidates

Takao Hiraki, MDa,*, Hideo Gobara, MDa, Tatsuhiko Iishi, MDa, Yoshifumi Sano, MDb, Toshihiro Iguchi, MDa, Hiroyasu Fujiwara, MDa, Nobuhisa Tajiri, MDa, Jun Sakurai, MDa, Hiroshi Date, MDb, Hidefumi Mimura, MDa, Susumu Kanazawa, MDa

a Department of Radiology, Okayama University Medical School, Okayama, Japan
b Department of Cancer and Thoracic Surgery, Okayama University Medical School, Okayama, Japan.

Received for publication March 14, 2007; revisions received July 4, 2007; accepted for publication July 10, 2007.

* Address for reprints: Takao Hiraki, MD, 2-5-1 Shikatacho, Okayama 700-8558, Japan. (Email: takaoh{at}tc4.so-net.ne.jp).

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.

Abbreviations and Acronyms CT = computed tomography; NSCLC = non–small cell lung cancer; PET = positron emission tomography; RFA = radiofrequency ablation; XRT = external beam radiation therapy






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