Approximately 20% of patients with lung metastases and resected primary soft tissue tumors have a limited number of metastases isolated to the lung and are potential candidates for surgical resection or metastasectomy. The role of thermal ablation in the treatment of thoracic malignancies has been growing for more than a decade It has become an established treatment alternative to surgical resection in patients with both primary lung cancer and metastatic disease, as well as in patients with locally recurrent tumor following treatment Complete ablation in potentially curative in Lung cancer ≤ 3 cm Local therapy such as surgery, radiotherapy and radiofrequency ablation for the relapsed sites could thus improve patient’s survival Ablative therapies can also be used as alternative modalities for localized control in the management of unrespectable lung tumors. Heat-based modalities cause localized tissue heating which results in irreversible coagulative tumor necrosis and localized tumor control. Microwave ablation (MWA) is performed by microwave energy (900–2,450 MHz) inducing dipole excitation, which in turn causes the water molecules to spin, transferring some of their kinetic energy and creating friction, resulting in heat generation and tissue hyperthermia. Selection Criteria are including, size, location, number and adjacent structures. Outcome data are limited regarding MWA therapy for lung cancer or pulmonary metastatic disease, although results would be expected to be at least as good for MWA because ablation zones trend toward being more robust, with less thermal sink effect. Wolf et al reported their results on mixed pulmonary tumors and found 1-, 2-, and 3-year overall survivals of 65%, 55%, and 45%, respectively. Unlike RFA, the overall survivals were not affected by index lesions > 3cm in size; however, there was a statistically significant decrease in local control for those tumors > 3cm in size.
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