1.1 There is evidence from imaging studies for the efficacy of microwave ablation for treating primary lung cancer and metastases in the lung, but evidence that the procedure improves clinical outcomes and quality of life is limited in quantity and quality. There is a risk of complications, including pneumothorax, which may have serious implications for patients with already compromised lung function. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit.
1.2 Clinicians wishing to undertake microwave ablation for treating primary lung cancer and metastases in the lung should take the following actions.
Inform clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having the procedure.
1.3 Patient selection for microwave ablation for treating primary lung cancer and metastases in the lung should be carried out by a multidisciplinary team, which should normally include a thoracic surgeon, an oncologist and a radiologist.
1.4 This procedure should only be carried out by radiologists who regularly undertake image-guided interventional procedures.
1.5 NICE encourages further research into this procedure. Research studies should report details of patient selection and adverse events. Outcomes should include local tumour control, survival and quality of life.