Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer

Table 1

Summary of studies reporting outcomes of RFA for NSCLC.

Author, year, and type of study	Reference Number	Center	Number of patients (tumors)	Patient age (y)	Number of patients or tumors according to cancer stage	Tumor size (cm)	Follow-up period (mo)	Toxicities	Local efficacy	Survival
§Lee et al., 2004	[10]	Chonbuk National University in South Korea	26 (27)	68*	IA/IB/II/III/IV: 1/9/1/7/8, respectively	5.6**	9*	Mortality (due to acute respiratory distress syndrome): 4%	Overall proportion of LTP: 73%; Proportion of LTP for stage I: 40%	1-/2-year OS: 50%/32%, respectively, median OS: 7 mo, 1-/2-year OS for stage I: 100%/53%, respectively, and mean OS for stage I: 21 mo
Fernando et al., 2005	[11]	Pittsburgh Medical Center in US	18 (21)	75*	I/II/III/IV: 9/2/3/4, respectively	2.8*	14*	Mortality (due to pulmonary embolus): 6%, PTX requiring drainage: 39%, and pneumonia: 11%	Proportion of LTP: 38%	1-/2-year OS: 83%/83%, respectively, and; mean OS: 21 mo
Pennathur et al., 2007	[12]	Pittsburgh Medical Center in US	19 (19)	78*	IA/IB: 11/8, respectively	2.6**	28* for alive patients	No mortality and PTX requiring drainage: 63%	Proportion of LTP: 42%	1-/2-year OS: 95%/68%, respectively
§Simon et al., 2007, retrospective	[13]	Brown University in US	75 (80)	NA	IA/IB: 56/19, respectively	3.0**	NA	Mortality (due to exacerbation of pulmonary fibrosis)	NA	1-/2-/3-/5-year OS: 78%/57%/36%/27%, respectively, median OS: 29 mo, and median OS for stages IA and IB: 30 mo and 25 mo, respectively (P = 0.58)
Hiraki et al., 2007, retrospective	[14]	Okayama University in Japan	20 (20)	76**	IA/IB: 14/6, respectively	2.4**	22*	No grade 3 or more toxicities, PTX requiring drainage: 4%, overall PTX: 57%, and pleural effusion: 17%	Proportion of LTP: 35%; 1-/2-/3-year LTP: 28%/37%/37%, respectively	1-/2-/3-year OS and CSS: 90%/84%/74% and 100%/93%/83%, respectively, mean OS: 42 mo, and; 1-/2-/3-year OS for stages IA and IB: 93%/93%/80% and 83%/67%/NA, respectively
§Lencioni et al., 2008, prospective	[15]	Multicenter in US, UK, Italy, Germany, and Australia	33 (38)	67*	IA/IB/recurrent NSCLC: 10/3/20, respectively	2.2**	NA	No mortality and PTX requiring drainage: 13%	Proportion of LTP: 13%	2-year OS/CSS for stage I: 75%/92%, respectively
Lanuti et al., 2009, retrospective	[16]	Massachusetts General Hospital in US	31 (34)	70*	IA/IB: 29/5, respectively	2.0**	17*	No mortality, PTX: 13%, chest tube placement: 8%, minor hemoptysis: 16%, hemothorax: 5%, pneumonia: 16%, pleural effusion: 21%, neuropathy: 3%, and bronchopleural fistula: 8%	Proportion of LTP: 32%	1-/2-/3-year OS and DFS: 85%/78%/47% and 82%/57%/39%, respectively,; and median OS and DFS: 30 mo and 26 mo, respectively
Zemlyak et al., 2010, retrospective	[17]	Stony Brook University in US	12	74**	I: 12	NA	NA	No mortality, PTX: 58%, and hemoptysis: 8%	Proportion of LTP: 33%	3-year OS/CSS/DFS: 88%/88%/50%, respectively
Hiraki et al., 2011, retrospective	[18]	Okayama University in Japan	50 (52)	75**	IA/IB: 38/12, respectively	2.1**	37*	No grade 4 or 5 toxicities, grade 3 toxicities: 6% (including pleural effusion [2%], bronchopleural fistula [2%], or empyema [2%]), grade 2 toxicities: 12% (including PTX and/or pneumonitis), and grade 1 PTX: 42%	Proportion of LTP: 31%	1-/2-/3-/5-year OS, CSS, and DFS: 94%/86%/74%/61%, 100%/93%/80%/74%, and 82%/64%/53%/46%, respectively, median and mean OS: 67 mo and 59 mo, respectively, median and mean DFS: both 42 mo, and 1-/2-/3-/5-year OS for stages IA and IB: 95%/89%/83%/66% and 92%/75%/50%/50%, respectively (P = 0.057)
§Huang et al., 2011	[19]	Fourth Military Medical University in China	237	68*	I/II/III/IV: 33/50/109/45, respectively	NA	NA	NA	NA	1-/2-/5-year OS: 80%/46%/24%, respectively
Ambrogi et al., 2011, prospective	[20]	University of Pisa in Italy	57 (59)	74**	IA/IB: 44/15, respectively	2.6**	46*	No mortality and PTX requiring drainage: 5%, minor complications: 20% (including pain [6%], small PTX [6%], tiny pleural effusion [4%], minor hemoptysis [3%], and chest wall hematoma [1%])	Overall proportion of LTP: 41%; Proportion of LTP for stage IA/IB: 34%/60%, respectively (P = 0.01)	1-/3-/5-year OS and CSS: 83%/40%/25% and 89%/59%/40%, respectively, median OS and CSS: 33 mo and 41 mo, respectively, median OS/CSS for stages IA and IB: 35 mo/52 mo and 20 mo/25 mo, respectively (OS and CSS significantly different between stages IA and IB), and 1-/3-/5-year OS for stage IA: 95%/71%/52%, respectively
Simon et al., 2012, retrospective	[21]	Brown University in US	82	76**	IA/IB/II/III/IV: 58/14/3/4/3, respectively	NA	16*	No mortality	NA	1-/2-/3-/5-year OS: 77%/62%/51%/21%, respectively, median OS: 37 mo, and; 1-/3-year OS for stages IA and IB: 84%/76% and 79%/67%, respectively
Lanuti et al., 2012, prospective	[22]	Massachusetts General Hospital in US	45 (55)	70*	I: 45	2.0**	32*	Overall PTX: 18% and PTX requiring drainage: 2%	Proportion of LTP: 33%	3-/5-year OS: 67%/31%, respectively, and median OS: 44 mo
Lee et al., 2012, retrospective	[23]	Seoul Medical Center in South Korea	40	72**	I/II/II/IV: 15/1/13/11, respectively	3.8** for stages I and II and; 4.6** for stages III and IV	56* for stages I and II and; 37* for stages III and IV	Major complication: 15% (including pneumomediastinum [3%], hemothorax [3%], PTX [8%], and hemoptysis [3%])	Proportion of LTP: 40%	1-/2-/5-year OS for stages I and II: 100%/77%/19%, respectively,; 3-year CSS for stages I and II: 33%, and; median OS for stage I: 38 mo

 *Median values, **mean values, and §the study is performed using a mixed population comprising both primary and metastatic lung cancer patients; data confined to NSCLC are extracted.
RFA = radiofrequency ablation, NSCLC = nonsmall cell lung cancer, NA = not available, PTX = pneumothorax, LTP = local tumor progression, OS = overall survival, CSS = cancer-specific survival, and DFS = disease-free survival.