Comparison between computed tomography-guided percutaneous microwave ablation and thoracoscopic lobectomy for stage I...

The study was conducted to investigate the effectiveness and cost of computed tomography (CT)-guided percutaneous microwave ablation (MWA) and thoracoscopic lobectomy for stage I non-small cell lung cancer (NSCLC).

We retrospectively analyzed the data of 46 and 85 patients with stage I NSCLC treated with CT-guided percutaneous MWA or thoracoscopic lobectomy, respectively, at our center from July 2013 to June 2015. Overall survival (OS), disease-free survival (DFS), local control rate, hospital stay, and cost were evaluated. Survival curves were constructed using the Kaplan-Meier method and compared using the log-rank test.

The one and two-year OS rates were 97.82% and 91.30% and 97.65% and 90.59% in the MWA and lobectomy groups, respectively. The one and two-year DFS rates were 95.65% and 76.09% and 95.29% and 75.29%, respectively. No significant differences were observed in log-rank analysis between the groups (P = 0.169). The hospital stays in the MWA and lobectomy groups were 6.62 ± 2.31 and 9.57 ± 3.19 days, respectively. The costs of MWA and lobectomy were US$3274.50 ± US$233.91 and US$4678.87 ± US$155.96, respectively. The differences were all significant (P = 0.003).

MWA and thoracoscopic lobectomy for stage I NSCLC demonstrate similar one and two-year OS and DFS, with no significant differences between the two groups. MWA involved a shorter hospital stay and lower cost, thus should be considered a better option for patients with severe cardiopulmonary comorbidity and patients unwilling to undergo surgery.