Radiofrequency, microwave and thermal ablation is increasingly used for treatment of primary lung tumours and oligometastatic disease in non-surgical candidates. Pleural complications of ablation, especially pneumothorax and effusion, are common1. We sought to explore identification, investigation and management of pleural complications of ablation in all patients treated at a tertiary UK hospital over 4-years.

Methods

Consecutive lung ablation procedures between Jan2018-Dec2022 were captured retrospectively by interrogating the[BI1]  radiology database (CRIS). Two independent physicians reviewed e-records for pleural complications and management of each case. Complications were graded using standard CTEP-AERS criteria.

Results

244 ablation procedures were conducted; 81 for primary malignancy and 163 for metastases. There were 138 males, median age 71years (IQR63-79).. Treatment with ablation was decided for all patients by radiology, surgery and oncology colleagues in the lung cancer meeting. 153(63%) patients had no or minor (Grade1) pleural complications post ablation. 76 (31%) patients had moderate (Grade2) effects. 15 (6%) patients had severe (Grade3) pleural complications requiring prolonged hospital admission or readmission or multiple pleural interventions as summarised in Table 1.

Discussion

This case series highlights the burden of pleural complications following ablation and the management requiring close working relationships with pleural and radiology colleagues. Future research would likely help determine optimal management of pleural complications post ablation treatment.