Cone-beam CT-guided thermal ablation vs video-assisted thoracic surgery in treatment of non-small-cell lung cancer: A propensity score matching analysis

AIMS: This study aimed to compare the safety and effectiveness of cone-beam CT (CBCT)-guided thermal ablation vs video-assisted thoracic surgery (VATS) in patients with stage I-IIIA non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: A total of 43 NSCLC patients underwent CBCT-guided thermal ablation, and 899 patients received VATS. After 1:1 propensity score matching (PSM), 32 patients were included in each cohort. Overall survival (OS), disease-free survival (DFS), recurrence rates, length of hospital stay, and complications were analyzed. RESULTS: The mean OS was 3.02 ± 1.31 years in the ablation group and 4.79 ± 2.87 years in the VATS group (P = 0.08). The mean DFS was 2.30 ± 1.55 years and 4.34 ± 2.98 years, respectively (P = 0.021). Local and distant recurrence occurred in five (15.6%) and seven (21.9%) patients in the ablation group, and in six (18.8%) and seven (21.9%) patients in the VATS group, with no significant difference in overall recurrence (P = 0.595). The hospital stay was significantly shorter in the ablation group (3.67 ± 2.04 days) than in the VATS group (8.21 ± 3.68 days, P < 0.0001). The incidences of pneumothorax (P = 0.430), infection (P = 0.086), pneumonia (P = 0.554), and fever (P = 0.230) were comparable between groups. CONCLUSION: CBCT-guided thermal ablation is a safe and effective treatment option for patients with stage I-IIIA NSCLC.