Wang Yufeng, Guo Runqi, Bie Zhixin, Li Bin, Li Xiaoguang
Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Thorac Dis. 2025 Aug 31;17(8):5534-5546. doi: 10.21037/jtd-2025-296. Epub 2025 Aug 14.
Ablation is an effective alternative treatment option for early-stage non-small cell lung cancer (NSCLC) patients who are not candidates for surgery or who refuse surgery. Microwave ablation (MWA) and cryoablation (CA) are both minimally invasive treatment techniques widely used in NSCLC patients, and their safety and efficacy have been verified. This study aimed to compare the safety and efficacy of co-ablation (Co-A) and MWA in the treatment of subpleural stage I NSCLC.
From December 2023 to December 2024, a retrospective analysis was conducted on 87 eligible patients (40 males, 47 females; mean age ± standard deviation: 72.03±9.07 years; age range, 31-88 years). Patients were divided into two groups based on the treatment method: a Co-A group and an MWA group. Recurrence-free survival (RFS) rates and complication rates were compared between the two groups.
Co-A had a significantly longer mean operative time compared to MWA (28.26±7.56 . 6.37±2.01 min, P<0.001). Postoperative analgesic intervention was significantly lower in the Co-A group (30.4% . 45.4%, P=0.03). Mean follow-up time was similar between groups (7.04±2.01 . 7.27±2.49 months, P=0.69). RFS rates at study end were 95.7% in Co-A and 100.0% in MWA (P=0.26). Common complications-pneumothorax, transient hemoptysis, and pleural effusion-showed no significant differences in incidence between the two groups (P>0.05). However, pneumothorax requiring chest tube drainage was significantly higher in the Co-A group (34.8% . 7.8%, P=0.008).
Compared with MWA, Co-A demonstrates no significant difference in efficacy or safety for treating patients with subpleural stage I NSCLC, but is associated with reduced perioperative pain and a longer operative duration.
对于不适合手术或拒绝手术的早期非小细胞肺癌（NSCLC）患者，消融是一种有效的替代治疗选择。微波消融（MWA）和冷冻消融（CA）都是广泛应用于NSCLC患者的微创治疗技术，其安全性和有效性已得到验证。本研究旨在比较联合消融（Co-A）与MWA治疗胸膜下I期NSCLC的安全性和有效性。
2023年12月至2024年12月，对87例符合条件的患者（40例男性，47例女性；平均年龄±标准差：72.03±9.07岁；年龄范围31-88岁）进行回顾性分析。根据治疗方法将患者分为两组：Co-A组和MWA组。比较两组的无复发生存率（RFS）和并发症发生率。
与MWA相比，Co-A的平均手术时间明显更长（28.26±7.56对6.37±2.01分钟，P<0.001）。Co-A组术后镇痛干预明显更低（30.4%对45.4%，P=0.03）。两组间平均随访时间相似（7.04±2.01对7.27±2.49个月，P=0.69）。研究结束时，Co-A组的RFS率为95.7%，MWA组为100.0%（P=0.26）。常见并发症——气胸、短暂咯血和胸腔积液——两组间发生率无显著差异（P>0.05）。然而，需要胸腔闭式引流的气胸在Co-A组明显更高（34.8%对7.8%，P=0.008）。
与MWA相比，Co-A在治疗胸膜下I期NSCLC患者时，疗效和安全性无显著差异，但与围手术期疼痛减轻和手术时间延长有关。
