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Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

  • Clinical Investigation
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Abstract

Purpose

To evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.

Materials and Methods

Eighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analyses

Results

Median follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.

Conclusions

Oversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression.

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Acknowledgments

We thank Pippa McKelvie-Sebileau and Jone Iriondo-Alberdi for medical editorial assistance.

Conflict of interest

Jean Palussiere declares no conflict of interest. Philippe Lagarde declares no conflict of interest. Anne Aupérin declares no conflict of interest. Frédéric Deschamps declares no conflict of interest. François Chomy declares no conflict of interest. Thierry de Baere declares no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Department of Interventional Radiology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Jean Palussiere

  2. Radiation Oncology Department, Institut Bergonié, Comprehensive Cancer Center, 229 cours de l’Argonne, 33000, Bordeaux, France

    Philippe Lagarde

  3. Unit of Biostatistics and Epidemiology, Institut Gustave-Roussy, 94805, Villejuif Cedex, France

    Anne Aupérin

  4. Department of Interventional Radiology, Institut Gustave-Roussy, 94805, Villejuif Cedex, France

    Frédéric Deschamps & Thierry de Baere

  5. Department of medical oncology, Institut Bergonié, Comprehensive Cancer Center, 229 cours de l’Argonne, 33000, Bordeaux, France

    François Chomy

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  1. Jean Palussiere
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Correspondence to Jean Palussiere.

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Palussiere, J., Lagarde, P., Aupérin, A. et al. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers. Cardiovasc Intervent Radiol 38, 160–166 (2015). https://doi.org/10.1007/s00270-014-0999-6

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  • DOI: https://doi.org/10.1007/s00270-014-0999-6

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