Percutaneous Microwave Ablation Under CT Guidance for Hepatocellular Carcinoma: a Single Institutional Experience

J Gastrointest Cancer. 2018 Sep;49(3):295-301. doi: 10.1007/s12029-017-9951-8.

Abstract

Background: Microwave ablation (MWA) is an emerging treatment for treatment of patients with hepatocellular carcinoma (HCC) not amenable of surgical resection.

Patients and methods: We searched for patients diagnosed as having small-, medium-, and large HCCs treated with MWA under CT guidance between 2010 and 2014. The main outcomes of interest were rates of complete ablation, complications, and overall survival. Rates of complete ablation were compared with Chi-square test, and estimated survival rates were calculated by means of Kaplan-Meier method.

Results: Thirty-two patients with 45 HCC nodules received MWA. Seventeen (37.8%) nodules were <3 cm (small), 15 (33.3%) between 3 and 5 cm (medium), and 13 (28.9%) > 5 cm (large). Complete ablation was obtained in 94.1% of small tumors, 80% of medium tumors, and 53.8% of large tumors (p = 0.03). Two patients had HCC located in risk area (paracardiac position). Minor complications occurred after seven procedures (15.5%). Estimated median survival was 37 months (95% confidence interval 11.97-62.02). One-year OS was 82.7%, 2-year survival 68.9%, and 3-year survival 55.2%.

Conclusion: MWA is a versatile ablative method that can be applied in HCC at various stages, and also in lesions located in risk areas.

Keywords: CT scan; Hepatocellular carcinoma; Microwave ablation; Percutaneous ablation.

MeSH terms

  • Ablation Techniques* / adverse effects
  • Ablation Techniques* / methods
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Microwaves / therapeutic use*
  • Middle Aged
  • Neoplasm Metastasis / diagnosis
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / therapy
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Treatment Outcome