Radiofrequency ablation for primary lung cancer and pulmonary metastases

Lung cancer remains one of the leading causes of death throughout the world. Although surgery is the gold standard treatment for lung cancer, the majority of patients are not resectable at the time of diagnosis. Even among patients who are potentially resectable, many are treated nonoperatively because of inadequate pulmonary reserve or advanced comorbidities. Despite aggressive multiple-drug regimens and the addition of radiation treatment, survival remains poor without surgery, and recurrence is the rule regardless of the initial treatment. Radiofrequency ablation can be performed via a percutaneous approach under conscious sedation, and side effects are generally mild and self limited, primarily consisting of pneumothorax. Radiofrequency ablation can be applied to primary pulmonary malignancies and metastatic lesions and is reported to achieve excellent local control in limited clinical series. Human and animal studies supporting the use of radiofrequency ablation for pulmonary malignancy are reviewed, and the current application of radiofrequency ablation and its limitations are described herein.