CT-guided ablation for stage I non-small cell lung cancer: a comparative study between cryoablation and microwave ablation

Background Computed tomography (CT)-guided tumor ablation has emerged as an important treatment option for patients with stage I non-small-cell lung cancer (NSCLC) who are poor surgical candidates. Here, the clinical performance and safety profiles of cryoablation (CA) and microwave ablation (MWA) for stage I NSCLC were compared. Methods Consecutive patients with stage I NSCLC treated with CT-guided CA or MWA between November 2022 and March 2025 were retrospectively enrolled. Outcomes evaluated included ablation effectiveness, long-term survival, and procedure-related complications, which were examined and compared between groups. Results Ninety-one patients were eligible for analysis in the present study, of whom 48 underwent CA and 43 underwent MWA. Baseline characteristics did not differ significantly between groups. Primary complete ablation rates were 93.8% for CA and 95.3% for MWA (P = 1.000); secondary complete ablation was achieved in all remaining cases in both cohorts. Patients treated with CA reported significantly lower procedural pain scores than those treated with MWA (median 1 vs. 3, P < 0.001). Median postoperative hospital stay was comparable (3 vs. 2 days, P = 0.376). Median progression-free survival (PFS) was 16 months for CA and 15 months for MWA (P = 0.763), while median overall survival (OS) was 23 and 24 months, respectively (P = 0.894). Complication rates were similar in both groups. Conclusions For stage I NSCLC, both CA and MWA demonstrated comparable therapeutic efficacy and safety. However, CA offered the advantage of reduced intraprocedural pain compared with MWA.