Computed tomography-guided percutaneous thermal ablation of pulmonary metastases: safety, local tumor control, and factors associated with treatment failure—a single-centre experience

PURPOSE: This study aimed to evaluate local tumor control, procedural safety, factors associated with treatment failure, and overall survival after computed tomography (CT)-guided percutaneous thermal ablation of pulmonary metastases. METHODS: This retrospective single-center study included 21 consecutive patients (10 men, 11 women; median age 58 years) who underwent CT-guided thermal ablation of pulmonary metastases by cryoablation (n = 14), microwave ablation (n = 5), or radiofrequency ablation (n = 2). Local tumor control at 6, 12, and 24 months was estimated by Kaplan-Meier analysis, and factors associated with failure were assessed by univariate analysis. Median follow-up was 50.8 months. RESULTS: = 0.659). Five-year overall survival was 82.5% (95% confidence interval, 46.1-95.3%). Distant disease progression occurred in 66.7%, and repeat ablation of the treated lesion was required in 1 patient (4.8%). CONCLUSION: CT-guided thermal ablation of pulmonary metastases achieved favorable local control with an acceptable safety profile. Larger tumor size was associated with local failure on univariate analysis. These associations are exploratory and, given the small number of events, require validation in larger multicenter cohorts. CLINICAL SIGNIFICANCE: In real-world practice, CT-guided thermal ablation offers a safe, lung-preserving option for selected patients with pulmonary metastases, achieving durable local control and favorable long-term survival. Tumor size may help refine patient selection and procedural planning.