Microwave ablation for primary or metastatic cancer in the lung

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 13 sources, which was discussed by the committee. The evidence included 3 systematic reviews and/or meta-analyses, 6 non-randomised comparative studies, 2 case series, 1 case report and 1 review of lung microwave ablation database. It is presented in the summary of key evidence section in the overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: disease progression, survival, reduction in tumour size, local recurrence and quality of life.

The professional experts and the committee considered the key safety outcomes to be: pneumothorax, pleural effusion, air embolism, bronchopleural fistula with prolonged air leak and bleeding.

Patient commentary was sought but none was received.

The committee was informed that microwave ablation is quicker and may be better tolerated than other ablation techniques.

The committee was informed that evidence on the efficacy of microwave ablation for primary and metastatic lung cancer is similar to other ablation procedures in terms of tumour size reduction. Other ablation procedures are also associated with similar complications.

The committee was informed that microwave ablation is not used to treat small-cell lung cancer.

This procedure may have a role for patients with primary or metastatic lung cancer who are unable to have surgery or whose tumour is not resectable.

There is more than 1 device available for this procedure.