Biological effects of radiofrequency thermal ablation on non-small cell lung cancer: results of a pilot study

OBJECTIVES: Radiofrequency ablation of lung tumors is an emerging technique with promising results. To achieve more information on its effects on pulmonary parenchyma and primary tumors, and to assess its efficacy in determining complete necrosis of the lesion, we led a pilot study consisting of thermal ablation followed by surgical resection. METHODS: Ten patients with early stage non-small cell lung cancer were enrolled in the study. In 5 patients radiofrequency ablation was achieved through thoracotomy just before the surgical resection. In another 5 patients radiofrequency ablation was performed percutaneously, under computed tomography guidance, and the surgical resection was performed after 15 days. RESULTS: Nine of the 10 patients enrolled in the study were available for analysis. There were 8 men and 1 woman with a mean age of 65.5 years. In all cases histologic diagnosis was available before radiofrequency ablation; adenocarcinoma was identified in 5 patients, and squamous cell carcinoma was identified in 4 patients. Microscopic examination showed complete necrosis of the tumor in 6 of 9 cases. No anatomopathologic alterations were seen in surrounding distant parenchyma. CONCLUSIONS: Our study confirms the safety of radiofrequency ablation, particularly underlining the possibility of performing a thermal lesion in the lung in a controlled manner. It also assesses that radiofrequency ablation may be effective in the local control of primary lung cancer. However, surgery still represents the mainstay of treatment of non-small cell lung cancer, and radiofrequency ablation must be reserved for high-risk patients.