Abstract 143P
Background
Ground-glass opacities (GGOs) in the lung, particularly in the hilar region, are increasingly detected and present unique management challenges. While lobectomy remains the standard treatment, microwave ablation (MWA) has emerged as a minimally invasive alternative for high-risk patients. This multicenter, prospective study compared the efficacy and safety of MWA and lobectomy in treating hilar GGOs.
Methods
A total of 100 patients with GGOs (≤50% solid components) were enrolled across five tertiary centers and allocated to MWA (n=50) or lobectomy (n=50) based on clinical evaluation and patient preference. The primary endpoint was 3-year recurrence-free survival (RFS). Secondary endpoints included complication rates, postoperative recovery, hospital stay, costs, and quality of life (QoL). Kaplan-Meier analysis was performed for survival outcomes, and Cox regression adjusted for confounders.
Results
At 36 months, the 3-year RFS was 88% in the MWA group and 90% in the lobectomy group (HR: 1.10, 95% CI: 0.72–1.45; P=0.68), demonstrating non-inferiority. Subgroup analysis showed comparable RFS for GGOs ≤2 cm (90% vs. 92%; P=0.77). Among high-risk patients (age >65 or with comorbidities), MWA demonstrated superior outcomes (3-year RFS: 85% vs. 78%). MWA had significantly fewer complications (12% vs. 30%; P < 0.01), including lower rates of pneumothorax (6% vs. 20%) and infections (2% vs. 10%). Recovery was faster withMWA (7 vs. 20 days; P < 0.01), with shorter hospital stays (2.5 vs. 7.5 days; P < 0.01) and 30% lower treatment costs. QoL scores 1 month post-treatment were higher in the MWA group (85/100 vs. 72/100), with less long-term respiratory impairment (2% vs. 15%).
Conclusions
MWA is a safe and effective alternative to lobectomy for hilar GGOs, achieving comparable 3-year RFS with fewer complications, faster recovery, and lower costs. These findings highlight MWA as a minimally invasive strategy for early-stage lung cancer, particularly for high-risk patients, and support its broader adoption in clinical practice.
Clinical trial identification
KY2021-263-B.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.