Radiofrequency Ablation of T1 Lung Carcinoma: Comparison of Outcomes for First Primary, Metachronous, and Synchronous Lung Tumors

Abstract

PurposeTo report and compare outcomes after radiofrequency ablation for treatment-naïve first primary, metachronous, and synchronous T1 lung tumors. Materials and MethodsThis institutional review board–approved retrospective study reviewed 29 patients (12 men and 17 women; median age, 73 y; age range, 55–86 y) with treatment-naïve T1 lung tumors treated with radiofrequency ablation. Tumors in the 29 patients included 21 T1a and 8 T1b first primary (n = 11), metachronous (n = 14), or synchronous (n = 4) tumors (adenocarcinoma, n = 25; squamous cell carcinoma, n = 3; unspecified, n = 1). Median tumor diameter was 14 mm (range, 10–26 mm). Surveillance computed tomography or positron emission tomography–computed tomography was performed over a median period of 28 months (range, 12–83 mo). Technical success and effectiveness rates and overall and progression-free 1-year, 3-year, and 5-year survivals were calculated according to stage, first primary, metachronous, and synchronous tumor status. ResultsTechnical success and effectiveness was 97%. Local control occurred in 17 of 21 T1a tumors (81%) and 5 of 8 T1b tumors (62.5%). The local progression rate of first primary tumors (5 of 11; 45%) was higher than that of metachronous (2 of 14; 14%; P = .07) and synchronous (0 of 4; P = .01) tumors. Estimated 1-year, 3-year, and 5-year local tumor progression-free survival was 79%, 75%, and 75%. Estimated 1-year, 3-year, and 5-year overall survival was 100%, 60%, and 14%. Survival outcomes were similar for patients with first primary, metachronous, or synchronous tumors. ConclusionsRadiofrequency ablation results in good local control and progression-free survival in patients with treatment-naïve T1 lung tumors, including patients with metachronous and synchronous tumors.