Microwave ablation for primary or metastatic cancer in the lung

Evidence on the safety of microwave ablation for treating primary lung cancer and metastases in the lung is adequate but shows it can cause infrequent serious complications. Evidence on its efficacy shows it reduces tumour size. But the evidence on improvement in survival, long-term outcomes and quality of life is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

Further research should be randomised controlled trials or disease registry studies. It should report patient selection, disease progression and quality of life, and take account of the effectiveness of managing oligometastatic disease in patients.

Clinicians who want to use microwave ablation to treat primary lung cancer and metastases in the lung should:

• Inform the clinical governance leads in their healthcare organisation.

• Give patients (and their families and carers as appropriate) clear written information to support shared decision making, including NICE's information for the public.

• Make sure that patients (and their families and carers as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.

• Audit and review clinical outcomes of all patients having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedures outcomes audit tool (for use at local discretion).

• Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

Healthcare organisations should:

• Make sure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.

• Regularly review data on outcomes and safety for this procedure.

People with primary or metastatic lung cancer should be referred to an appropriately constituted multidisciplinary team.

The procedure should only be done in specialist centres by clinicians with specific training in this procedure.