Cryoablation for ground-glass nodules: Indications and short-term outcomes

We prospectively applied cryoablation to nonsubpleural small ground-glass nodules (GGNs) with risk factors for growth (high-risk GGNs). Herein, we present our inclusion criteria and short-term outcomes.

This is an interim report from a prospective, single-arm observational cohort study of cryoablation for high-risk GGNs. Inclusion criteria were GGN size between 8 and 20 mm; nonsubpleural GGNs; presence of risk factor for growth; clinically predicted as minimally invasive based on standardized uptake value and consolidation-to-tumor ratio; patients aged 20 to 65 years, those with a history of prior lung cancer surgery, or those with impaired pulmonary function test results; and provision of informed consent after thorough explanation. Exclusion criteria were GGNs located within 1 cm of a major vessel or main bronchus, evidence of nodal or distant metastasis, and severe coagulopathy.

A total of 14 patients underwent cryoablation for GGNs. The mean age was 68.1 ± 10.5 years. All patients had multiple GGNs, and 11 patients (78.6%) had a history of lung cancer surgery. Mean GGN size was 12 ± 5 mm with standardized uptake value 0.5 ± 0.6 and consolidation-to-tumor ratio 0.6 ± 0.3. All lesions were successfully encompassed within the target -40 °C isotherm zone with 10-mm safety margins. Only Common Terminology Criteria for Adverse Events grade 1 complications occurred. The median hospital stay was 2 days.

We have presented the indications of cryoablation for GGNs. This study demonstrates that cryoablation can be safely performed in carefully selected patients, achieving favorable short-term safety outcomes.