Safety and feasibility of computed tomography–guided radiofrequency ablation for treating high-risk pulmonary nodules in postoperative lung cancer patients

Background Lung cancer remains the leading cause of cancer-related deaths globally. Patients with postoperative recurrence typically have limited treatment options. This study evaluated the safety and feasibility of computed tomography–guided radiofrequency ablation for treating high-risk pulmonary nodules in patients who have undergone lung cancer surgery and are ineligible for reoperation. Methods We retrospectively analyzed 40 patients (16 men and 24 women, aged 41–78 years) with radiologically suspicious recurrent nodules following lung cancer resection who were treated with radiofrequency ablation at West China Hospital (July 2023–August 2024). Outcomes included procedural success, occurrence of complications, hospitalization duration, 30-day mortality, and imaging response. Results All procedures were technically successful. Five minor complications occurred in 12.5% of the patients, including fever (n = 2) and pneumothorax (n = 3). No deaths occurred within 30 days, and no major adverse events (e.g. hemothorax) were observed. The median postoperative length of hospital stay after ablation was 2.0 days. Furthermore, 82.5% of the patients were followed up and had achieved complete ablation at the 3-month mark. Conclusion Computed tomography–guided radiofrequency ablation is a minimally invasive, safe, and effective option for managing high-risk pulmonary nodules in postoperative lung cancer patients who are deemed ineligible for reoperation. Its low complication rate, rapid recovery, and promising local control support its integration into multimodal treatment algorithms. Larger prospective studies are needed to validate long-term outcomes.