ArticleTranslational lung cancer research2026
Electromagnetic navigation bronchoscopy-guided three-dimensional conformal microwave ablation for unresectable peripheral high-risk pulmonary nodules: a mid-term assessment with no real-time intraoperative CT/cone-beam computed tomography guidance.
Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Radical resection is the gold standard for high-risk pulmonary nodules; however, many patients are not candidates for surgery or who decline surgery. Electromagnetic navigation bronchoscopy-guided three-dimensional conformal microwave ablation (ENB-DCMA) is a promising minimally invasive option. This study aimed to assess the mid-term safety and efficacy of a novel ENB-DCMA strategy which employs three-dimensional conformal planning to offset respiratory-induced lesion displacement. Methods: In this single-center retrospective study, we enrolled consecutive patients with peripheral high-risk pulmonary nodules who received ENB-DCMA owing to unsuitability for or refusal to surgery and radiotherapy between March 2021 and August 2023. The three-dimensional conformal strategy enlarged the ablative margin to compensate for respiratory-induced target motion exploratively, in the absence of real-time intraoperative computed tomography/cone-beam computed tomography (CT/CBCT) guidance. The primary efficacy endpoint was local progression-free survival (LPFS) post-ablation. Safety was evaluated according to the incidence of adverse events. Results: In total, 50 patients with 62 eligible pulmonary nodules were included, with 65 ablation procedures performed in total, including repeated ablation for three lesions. The technical success rate of this procedure was 95.2%. No procedure-related mortality was observed. The median follow-up was 37.1 (range, 14.7-59.9) months. The overall 3-year LPFS rate was 82.3%, and this rate reached 95.8% among patients with sub-solid nodules. The overall incidence of adverse events was 18.0% (9/50), including 12.0% (6/50) pneumothorax, 2.0% (1/50) postoperative fever, and 4.0% (2/50) self-limiting pulmonary hemorrhage; the rate of events requiring intervention was 4.0% (2/50). Conclusions: ENB-DCMA serves as a safe and feasible minimally invasive therapeutic option for patients with high-risk pulmonary nodules. Further multicenter prospective trials are required to verify its long-term outcomes and broader clinical popularization value.
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