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 |
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| 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 |
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| 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 |
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| §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) |
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| 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 |
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| §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 |
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| 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 |
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| 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 |
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| 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) |
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| §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 |
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| 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 |
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| 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 |
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| 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 |
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| 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.