Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs
In patients with stage IA NSCLC, image-guided thermal ablation is a safe and effective treatment with minimal complications and acceptable long-term oncological and survival outcomes that are comparable to SBRT and sublobar resection.
(C, Moderate)Image-guided thermal ablation is a safe and effective treatment option for patients with recurrent NSCLC.
(C, Moderate)Thermal ablation should be considered alongside surgical resection and SBRT in patients who require preservation of lung parenchyma function.
(C, Moderate)Image-guided thermal ablation of metastatic disease to the lungs may be appropriate in some patients, including those with a limited number of small (≤3 cm) lung metastases.
(C, Weak)RFA, CA, and MWA are all appropriate modalities for image-guided thermal ablation of primary or secondary lung tumors. The method of ablation should be determined by lesion characteristics and risk mitigation and should be left to the discretion of the operating physician.
(C, Weak)Biopsy of lung tumors is recommended before or during thermal ablation, when safe and possible.
(D, Weak)Future research in the form of comparative studies (either randomized controlled trials or well-conducted cohort studies) is required to strengthen the evidence base for image-guided thermal ablation in patients with inoperable stage I NSCLC, recurrent NSCLC, and metastatic lung disease.
(E, Moderate)Recommendation Grading
Overview
Title
Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs
Authoring Organization
Society of Interventional Radiology
Publication Month/Year
August 1, 2021
Last Updated Month/Year
July 14, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Home health, Hospital, Outpatient
Intended Users
Social worker, physician, nurse practitioner, nurse, physician assistant
Scope
Treatment
Diseases/Conditions (MeSH)
D002289 - Carcinoma, Non-Small-Cell Lung
Keywords
lung cancer, non-small-cell lung carcinoma (NSCLC), biopsy, thermal ablation, cryoablation, microwave ablation, radiofrequency ablation
Source Citation
Genshaft SJ, Suh RD, Abtin F, Baerlocher MO, Chang AJ, Dariushnia SR, Devane AM, Faintuch S, Himes EA, Lisberg A, Padia S, Patel S, Tam AL, Yanagawa J. Society of Interventional Radiology Multidisciplinary Position Statement on Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs: Endorsed by the Canadian Association for Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology. J Vasc Interv Radiol. 2021 Aug;32(8):1241.e1-1241.e12. doi: 10.1016/j.jvir.2021.04.024. PMID: 34332724.