High-powered percutaneous microwave ablation of stage I medically inoperable non-small cell lung cancer: a...

To retrospectively evaluate the feasibility and outcome of using high-powered percutaneous microwave ablation (MWA) in treating medically inoperable early stage non-small cell lung cancer.

From November 2010 to June 2012, 15 patients underwent CT-guided MWA of 15 tumours in 16 sessions. One patient had a second ablation session for local tumour progression. Each tumour had a diameter of 40 mm or less (median 24 mm). Treatment outcome was evaluated using modified response evaluation criteria in solid tumours criteria based on follow-up contrast-enhanced CT studies and 18-F fluorodeoxyglucose positron emission tomography scans.

Thirty-three ablation cycles of 15 tumours were performed in 16 sessions (2.1 per session), with a median duration of 2.5 min per ablation. Treatment was completed in all cases with no 30-day mortality. At a median follow-up period of 1 year, local progression was identified following 5/16 (31%) ablation sessions. Eleven out of 16 (69%) of MWAs had shown local treatment response, with 9/11 displaying complete response and 2/11 displaying partial response. Local progression on follow up was predominantly seen in pleural-based tumours that were greater than 30 mm in longest axial diameter (4/5 cases). The main adverse event was a pneumothorax, which occurred in 10/16 (63%) of procedures, but a chest tube was only required in 2/16 (13%) cases.

Percutaneous MWA in early stage non-small cell lung cancer is well tolerated and has promising midterm outcomes.