317 - Predictors of Local Recurrence After Image-Guided Thermal Ablation for Stage IA Non-Small Cell Lung Carcinoma

Wednesday, April 15, 2026

11:33 AM - 11:42 AM ET

Presenting Author(s)

EW

Eshan Walia

Research Assistant
University of California, Los Angeles, United States

Author/Co-author(s)

AP

Ashton Peasley

Research Assistant
University of California, Los Angeles, United States
JN

John Nikitas, MD

Assistant Professor
University of Pennsylvania, United States
BV

Bianca Villegas, MPH

Statistician
University of California, Los Angeles, United States
GK

Grace Kim, PhD, MS

Professor
UCLA, United States
MY

Megumi Yokomizo, BA

Clinical Research Supervisor
University of California, Los Angeles, United States
SG

Scott Genshaft, MD

Associate Clinical Professor
UCLA Interventional Radiology, United States
Robert Suh, MD

Clinical Professor, Radiological Sciences
David Geffen School of Medicine at UCLA, United States
FA

Fereidoun Abtin, MD

Professor
David Geffen School of Medicine at UCLA, United States

Purpose: To evaluate predictors of recurrence in patients with Stage IA non-small cell lung carcinoma (NSCLC) treated with image-guided thermal ablation (IGTA).

Materials and Methods: This is an IRB-approved, HIPAA-compliant retrospective analysis of the institutional lung ablation database from 2011 to 2018, of patients who underwent IGTA for Stage IA NSCLC. 85 patients (mean age: 71.9 ± 9.9 years) who underwent a single IGTA of the lung. Data on patients’ demographics, tumor characteristics, procedural techniques, and local of death were obtained. Multivariable Cox proportional hazards models were constructed to assess predictors of local recurrence, with 5-year progression-free survival (PFS) being the endpoints. Model 1 included variables for age, ablation modality, tumor margin morphology, tumor size, and sedation type (n=77); Model 2 excluded margin characteristics to increase sample size (n=84). Hazard ratios (HRs), 95% confidence intervals (CIs), and p-values were reported.

Results: All procedures were technically completed successfully. Lung ablations were performed on 16 (18.8%) T1a, 45 (52.9%) T1b, and 24 (28.2%) T1c tumors. The mean maximum tumor diameter was 16.6 ± 6.3 mm. Adenocarcinoma (82.3%) was the most common histology, followed by squamous cell carcinoma (15.2%) and carcinoid (2.3%). Ablation modality included microwave ablation (48.3%), Cryoablation (43.5%), and RFA in 8.2% of IGTA. Local recurrence occurred in 8 patients (9.4%), all with T1b (100%), of which 6 underwent repeat ablation with no further recurrence, achieving durable local control in 97.6% of patients. Across both models, none of the variables reached statistical significance for recurrence (p >0.05). However, spiculated tumor margins showed a clinical association with increased recurrence risk (Model 1: HR=4.35, p=0.057, 95% CI:0.96-19.78). Microwave ablation was associated with a 46% lower risk of local recurrence or death compared to cryoablation (Model 1: HR = 0.54, p=0.281, 95% CI:0.17-1.66). History of COPD (Model 1: HR=2.22, p=0.104, 95% CI:0.85-5.82) was also associated with elevated, though non-significant, hazard ratios. Age at ablation showed a consistent but modest risk increase per year (Model 2: HR=1.02, p=0.560, 95% CI:0.96-1.07).

Conclusion: IGTA is an effective treatment for Stage I NSCLC, achieving acceptable low recurrence rates. No individual variable demonstrated as a statistically significant predictor for recurrence. However, spiculated tumor margins and history of COPD are associated with higher risk of recurrence.