Percutaneous CT-guided thermal ablation of primary lung cancer

<bold>Background:</bold> Thermal ablation is a minimally invasive treatment for patients with inoperable localized NSCLC. <bold>Objective:</bold> This retrospective study was performed to evaluate the effectiveness and safety of thermal ablation in patients with NSCLC. <bold>Methods:</bold> Twenty-five patients with a biopsy-proven stage IA inoperable NSCLC were treated with microwave ablation (MWA) between January 2019 and January 2021. Staging was established by a positron emission tomography-computed tomography (PET-CT) prior to ablation. Study endpoints were local control rates at 1-year and 2-years, overall survival (OS), disease free survival (DFS), recurrence and complication rates. Treatment outcome evaluation was based on follow-up CT studies and PET-CT scans. Complications requiring immediate intervention were also recorded. <bold>Results:</bold> Twenty-five patients (M:F = 16:9; mean age 72.56±8.05) were treated with CT-guided MWA. The average size of the lesion was 2.01±0.63cm (95%CI: 1.74-2.27, range: 1.3-3 cm). No procedure-related mortality was recorded. The overall complication rate was 20%. Pneumothorax, local haemorrhage and low-grade fever were the most common complications with an incidence rate of 12%, 8% and 8% respectively. The average disease-free survival was 36.36 ± 2.59 months (95%CI 31.26-41.45, Kaplan-Meier) while the overall survival was 38.40 ± 2.00 months (95%CI: 34.46-42.33 Kaplan-Meier). One patient showed increasing soft tissue mass at the ablation site 6 months post-treatment and MWA was repeated. The 1-year and 2-years OS rates were 96% and 88% respectively, while the rates of local control were at 1-year and 2-years 88% and 84% respectively. <bold>Conclusion:</bold> MWA therapy is a promising and safe treatment option for early-stage NSCLC.