Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy

SIMPLE SUMMARY: Up to 56% of lung cancer patients present with metastatic disease at initial diagnosis. Whereas these patients were historically deemed incurable, recent evidence supports the use of thermal ablation in stage IV non-small cell lung carcinoma with limited sites of metastasis (oligometastatic disease). In this review, we discuss the main results (local efficacy, overall survival, progression-free survival, safety and quality of life) of studies evaluating thermal ablation as a local ablative therapy for oligometastatic non-small cell lung carcinoma. ABSTRACT: A growing body of evidence shows improved overall survival and progression-free survival after thermal ablation in non-small cell lung carcinoma (NSCLC) patients with a limited number of metastases, combined with chemotherapy or tyrosine kinase inhibitors or after local recurrence. Radiofrequency ablation and microwave ablation are the most evaluated modalities, and target tumor size <3 cm (and preferably <2 cm) is a key factor of technical success and efficacy. Although thermal ablation offers some advantages over surgery and radiotherapy in terms of repeatability, safety, and quality of life, optimal management of these patients requires a multidisciplinary approach, and further randomized controlled trials are required to help refine patient selection criteria. In this article, we present a comprehensive review of available thermal ablation modalities and recent results supporting their use in oligometastatic and oligoprogressive NSCLC disease along with their potential future implications in the emerging field of immunotherapy.