Mid-term efficacy and safety of transbronchial cryoablation for stage IA peripheral lung cancer: a retrospective analysis.

Background: Transbronchial cryoablation is an emerging treatment option for patients with early-stage lung cancer who are not candidates for surgery or who decline surgery. However, evidence regarding its efficacy and safety remains limited. This study aims to retrospectively evaluate the mid-term efficacy and safety of transbronchial cryoablation in patients with stage IA peripheral lung cancer. Methods: This single-center retrospective study included patients with stage IA peripheral lung cancer who received transbronchial cryoablation due to unsuitability for or refusal to surgery and radiotherapy from September 2022 to October 2025. All patients underwent transbronchial cryoablation under the guidance of either navigation bronchoscopy or robotic bronchoscopy in combination with cone-beam computed tomography (CBCT). The efficacy was assessed by the local progression-free survival (LPFS), and safety was evaluated based on the incidence of adverse events occurring during or within 30 days after the ablation procedure. Results: A total of 23 patients with 24 tumors underwent 25 transbronchial cryoablation procedures. The median age of patients was 67.0 years, and the mean lesion size was 14.2±4.2 mm. Among all lesions, six lesions were solid nodules, 18 lesions were ground-glass nodules. The LPFS rate remained stable at 89.2% throughout the follow-up period at 1, 2, and 3 years. Two patients with solid nodules experienced local progression at 6 and 9 months after cryoablation, respectively. Adverse events and intervention-acquired adverse events were reported in 16.0% and 0.0% of participants. Conclusions: Our findings suggest that transbronchial cryoablation may be an effective and safe option for stage IA peripheral lung cancer; however, definitive confirmation of its efficacy awaits prospective, large-scale randomized controlled trials.