Surgery is considered the best treatment in Stage I non-small cell lung cancer. Local non–surgical therapies (radiotherapy, thermoablation) are becoming valid alternative to surgery in high risk patients (poor cardiac or pulmonary function, elderly patients). Patients submitted in our Department to Microwave thermoablation (MW) were compared with a cohort of patient submitted to lung lobectomy in the same period of time, abstracted from our database with a propensity match method. The study was retrospective on data recorded prospectively. Primary endpoint was overall survival. From June 2009 to October 2014 in our Department, 36 patients underwent MW for Stage I non-small cell lung cancer (NSCLC) or lung metastasis. From our database were abstracted 41 patients with a propensity match method, submitted to lung lobectomy. Two groups were comparable by age, diagnosis, stage and gender. MW group resulted elder than Surgery group (75,5 vs 72,2 years; p<0,001). Lesion diameter was greater in MW group (20,9 vs 26,5 cm; p<0,001). Overall survival, analyzed by actuarial survival curve, was comparable (Logrank test p=0,2). In our experience, in a propensity match evaluation, lung MW thermoablation resulted non inferior than lung lobectomy in terms of overall survival. Even though surgery is still considered the first choice in patients affected by Stage I NSCLC or lung metastasis, lung MW thermoablation is confirmed as a valid alternative treatment in high risk patients. Randomized prospective studies are mandatory.
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