Microwave ablation treatment for medically inoperable stage I non-small cell lung cancers: long-term results

In the present study, we aim to show the results of microwave ablation (MWA) for medically inoperable stage I non-small cell lung cancers (NSCLCs) with long-term follow-up.

From Feb 2011 to Mar 2016, patients with histologically proven clinical stage I NSCLC were treated with CT-guided MWA and retrospectively analyzed. The primary end point was overall survival (OS). Secondary end points included disease-free survival (DFS), cancer-specific survival (CSS), and complications.

A total of 105 patients with 105 lesions underwent MWA. The mean age was 70.7 years (range: 40–86 years), and the mean diameter of all lesions was 2.40 cm (range: 0.9–4.0 cm). Adenocarcinoma was the most common histological type (77, 73.3%), followed by squamous cell carcinomas (21, 20%) and undefined NSCLC (7, 6.7%). With a median follow-up of 54.8 months, the median DFS was 36.0 months, and 1-, 3-, and 5-year DFS rates were 89.5%, 49.4%, and 42.7%, respectively. The median CSS and OS were 89.8 and 64.2 months, respectively. The OS rate was 99% at 1 year, 75.6% at 3 years, and 54.1% at 5 years, while the CSS rates were 99%, 78.9%, and 60.9%, respectively. Patients with stage IB lesions had significant shorter DFS (22.3 months vs. undefined, HR: 11.5, 95%CI: 5.85–22.40) and OS (37.3 vs. 89.8 months, HR: 8.64, 95% CI: 4.49–16.60) than IA disease.

MWA is a safe, effective, and potentially curative therapy for medically inoperable stage I NSCLC patients.