Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation

Sun, Aixue; Cheng, Zhili; Wu, Panpan; Sheng, Yuehong; Qu, Xiujuan; Lu, Wen L.; Zhao, Cheng-Gong; Gao, Qian

doi:10.3748/wjg.v21.i10.2997

Cited by 46 publications

(30 citation statements)

References 37 publications

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“…A component of this could include the increasing size of tumors treated with MWA, which has been shown in other studies to be associated with increased rates of local recurrence (19,20). However, the local recurrence rate remains lower than rates typically reported in the literature for HCC, particularly in comparison to percutaneous MWA (21).…”

Section: Discussionmentioning

confidence: 74%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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Background: Microwave ablation (MWA) of hepatocellular carcinoma (HCC) offers local regional treatment that can be safely and effectively performed, even in patients with advanced liver disease. We update results from our group's previous analysis of operative MWA for HCC. Results: Two hundred and nineteen patients were included with a total of 340 tumors treated with operative MWA. Median tumor size was 3.2 cm (range, 1-6 cm). Cirrhosis was present in 89.5% of patients, 60.7% had hepatitis C, and 8.2% had hepatitis B. Thirty-five point nine percent were Child-Pugh class B/C. Ninety-six point eight percent of MWA procedures were performed laparoscopically. Four deaths occurred within 30 days (1.8%). Clavien-Dindo grade III complications occurred in 3.2% of patients. Complete ablation was identified in 97.1% of tumors, with local recurrence rates of 8.5% at 10.9 months median follow up (0-80 months). Regional recurrence occurred in 34.8% of patients at 10.9 months median follow up and metastatic recurrence was seen in 8.1% of patients. One year overall survival was 80.0% and 2-year survival was 61.5%. Conclusions:We propose that laparoscopic MWA offers a low morbidity approach for treatment of HCC affording low rates of local recurrence even for patients with significant underlying liver dysfunction. This large series offers insight into outcomes of this modality as definitive treatment for patients with HCC.

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Section: Discussionmentioning

confidence: 74%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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“…Faster ablation times, larger ablation zones, and higher intratumoral temperatures have been observed with MWA in ex vivo bovine [58,59] and in vivo porcine [60] animal models. Given its increased efficacy in ablation and shorter time to achieve ablations, MWA has increasingly been used in treating HCC [61,62,63,64,65,66,67]. Liang et al [62] evaluated a series of 288 patients with HCC who underwent percutaneous MWA and demonstrated 1-, 2-, 3-, 4-, and 5-year cumulative survival rates of 93, 82, 72, 63, and 51%, respectively.…”

Section: Local Ablative Therapymentioning

confidence: 99%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. Summary: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques. Key Message: Advances in image-guided locoregional therapies, including local ablative therapy and transarterial therapy, have led to a major breakthrough in the management of HCC. Both survival rates and cure rates of patients with HCC have improved markedly since the introduction of these techniques. Practical Implications: Radiofrequency ablation is currently considered as an alternative to surgical resection for patients with early-stage HCC. A newer technique of ablation such as microwave ablation is increasingly being used, especially for large HCC. Transarterial chemoembolization has become a standard care for asymptomatic patients with multinodular tumors in intermediate-stage disease, and transarterial radioembolization has become the method of choice in HCC cases with portal vein thrombosis. Moreover, combination treatment modalities, such as thermal-based ablation combined with transarterial chemoembolization or ¹²⁵I seed implant brachytherapy, may further broaden their clinical indications for HCC. Moreover, use of localized radiation in combination with thermal ablation has been reported to improve tumor control and long-term survival.

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“…In their study one patient died due to liver abscess-related septicemia (30-day mortality rate 0.5 %). The cumulative recurrence-free survival and overall survival (OS) rates at 1, 2 and 3 years were 51 %, 36 %, 27 % and 89 %, 74 %, 60 %, respectively [45].…”

Section: Mwa Results In Hccmentioning

confidence: 99%

Microwave Ablation (MWA): Basics, Technique and Results in Primary and Metastatic Liver Neoplasms – Review Article

Vogl

Nour-Eldin

Hammerstingl

et al. 2017

Fortschr Röntgenstr

134

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ZUSAMMENFASSUNGHintergrund Der lokoregionale interventionelle onkologische Behandlungsansatz ist eine anerkannte Behandlungsoption bei Lebermalignomen, insbesondere beim hepatozellulären Karzinom (HCC) und oligonodulären Lebermetastasen. Material und Methode ABSTR AC T PurposeThe locoregional interventional oncological treatment approach is an accepted modality for liver neoplasms, especially for hepatocellular carcinoma (HCC) and oligonodular liver metastases. Materials and MethodsThe main aim of ablation therapies like microwave ablation (MWA) is to eradicate all malignant cells in a minimally invasive technique under imaging guidance while preserving the healthy tissue with a sufficient safety margin (at least 5 mm) surrounding the ablated lesion.Results Ablation therapy can be performed via a percutaneous, laparoscopic or intraoperative approach under ultrasound, MRI or CT guidance for adequate localization and monitoring of the ablation process.Conclusion Ablation is the method of choice for oligonodular HCCs ≤ 3 cm. The technical success rate varies from 88 % to This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.98 % and progression-free survival (PFS) at 3 years from 27 % to 91.7 %. The same criteria apply to the therapy of liver metastases. Key Points▪ Careful selection of patients proves to be essential for optimum results of MWA ▪ Interventionists should be familiar with all aspects of complication and rapid assessment of imaging methods in order to evaluate induced damage by thermal ablation ▪ MWA seems to have some advantages over radiofrequency ablation, like shorter ablation time, less pain, less heat sink effect; however, scientific proof is needed

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Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation

Abstract: Percutaneous MWA is a relatively safe and effective treatment for patients with medium-sized HCC.

Cited by 46 publications

References 37 publications

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Microwave Ablation (MWA): Basics, Technique and Results in Primary and Metastatic Liver Neoplasms – Review Article

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