94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Surg.
Sec. Thoracic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1547048
A Retrospective Study of Microwave Ablation and Thoracoscopic Surgery for Multiple Primary Lung Cancer: a propensity score matching analysis
Provisionally accepted- Yunnan Cancer Hospital, Kunming, Yunnan Province, China
Purpose: Microwave ablation (MWA) is a minimally invasive local treatment with demonstrated safety and efficacy, but its role in managing multiple primary lung cancer (MPLC) is not well-established. This study retrospectively evaluates the clinical effectiveness of MWA compared to video-assisted thoracoscopic surgery (VATS) in treating MPLC. Materials and methods: A retrospective analysis was conducted using data from patients with non-small cell lung cancer (NSCLC) treated at Peking University Cancer Hospital Yunnan Hospital between January 2021 and April 2024. All patients had undergone surgical resection for their first primary lung cancer (FPLC) and subsequently received either MWA or VATS for second primary lung cancer (SPLC). After 1:1 propensity score matching (PSM), 202 patients per group were included. Study endpoints included progression-free survival (PFS), overall survival (OS), complications, and pulmonary function changes.Results: Median follow-up was 24.47 months. Survival analysis revealed a statistically significant difference in PFS between MWA and VATS groups (HR=2.74, 95% CI: 1.40–5.36, p=0.006), while OS showed no difference (HR=1.41, 95% CI: 0.45–4.36, p=0.56). The incidence of grade ≥II complications was significantly lower in the MWA group (p<0.001). Pulmonary function tests indicated no significant changes in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1%, maximal voluntary ventilation (MVV), and diffusion capacity of the lung for carbon monoxide%(DLCO%) before and 1-3 month post MWA (p>0.05). Conclusions: In MPLC patients with stage IA SPLC, VATS demonstrates a greater clinical efficacy advantage in terms of local tumor control compared to MWA. Additionally, MWA provided significant advantages in reducing complication severity and preserving pulmonary function. These findings suggest that the therapeutic approach combining surgery with MWA represents a safe and effective option for MPLC.
Keywords: Multiple primary lung cancer, Video-assisted thoracoscopic surgery, Microwave ablation, complication, Pulmonary Function
Received: 17 Dec 2024; Accepted: 26 Feb 2025.
Copyright: © 2025 Li, Gao, Mao, Yang, Chen, Wang and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yunchao Huang, Yunnan Cancer Hospital, Kunming, Yunnan Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.