Thermal ablation included in multimodality treatment predicts enhanced survival in advanced non-small cell lung cancer: a propensity score-matched outcome study.

Abstract

Background: Advanced non-small cell lung cancer (NSCLC) presents significant treatment challenges, with limited effective therapies for late-stage patients. This study aimed to evaluate the impact of adding thermal ablation (TA) in treatment regimens for advanced NSCLC to improve survival outcomes.

Methods: A retrospective cohort study was conducted at a medical center in Taiwan, analyzing data from 1,083 patients diagnosed with stage IIIB or IV NSCLC between 2008 and 2020. Survival outcomes were compared between patients treated with TA and those who received conventional therapies. Statistical analyses, including propensity score matching and Cox regression models, were used to account for potential confounders.

Results: The TA group demonstrated a significantly longer median overall survival (OS) of 37 months compared to 15 months in the non-TA group (p < 0.001), with five-year OS rates of 32.4% and 9.8%, respectively. Median progression-free survival (PFS) was 36 months in the TA group versus 14 months in the non-TA group, with five-year PFS rates of 24.1% versus 6.3% (p < 0.001). Subgroup analyses showed enhanced survival in patients undergoing targeted therapy and chemotherapy when TA was included. Survival outcomes with TA were comparable to lobectomy, offering a less invasive option for selected patients.

Conclusions: Thermal ablation is associated with significant improvements in OS and PFS in patients with advanced NSCLC, providing a viable treatment option for those not eligible for surgery. The results support the integration of TA into standard care protocols, with further prospective studies needed to confirm these findings and optimize treatment strategies.