<p>Image-Guided Percutaneous ‎Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results</p>

Abstract

ObjectiveThe aims of this study were to compare the clinical outcomes between image-guided percutaneous microwave ablation (MWA) and cryoablation (CRA) in patients with hepatocellular carcinoma (HCC) in high-risk locations and to identify the prognostic factors associated with the two treatment methods.MethodsThis retrospective study was institutional review board approved. A total of 120 patients (88 men and 32 women) with one hundred and thirty-four HCC lesions in high-risk locations from April 2014 to March 2018 were reviewed. Sixty-four patients underwent MWA and 56 patients underwent CRA. Survival, recurrence and complications were compared between the two groups. Effect of changes in key outcomes (i.e., overall survival (OS), recurrence-free survival (RFS) and local tumor progression (LTP)) was statistically analyzed with the log rank test. Univariate and multivariate analysis were performed on clinicopathological variables to identify factors affecting intermediate-term outcomes.ResultsThe OS and RFS after MWA were comparable to those of CRA (P =0.141, and P=0.469, respectively). The LTP and major complication in MWA group was higher than those in CRA group (P=0.003, and P=0.039). Univariate analysis showed that age (P=0.007), tumor size (P=0.001), and Child-Turcotte-Pugh (CTP) grade (P=0.003) were risk factors for OS, and multivariate analysis results showed that older age (≥65 years) (P=0.002, HR:3.338, 95% CI:1.928–5.281), 3.0–5.0 cm in size (P<0.001, HR: 3.312, 95% CI: 1.872–4.489) and CTP grade B (P=0.001, HR:3.382, 95% CI: 1.882–5.902) were independently associated with poor OS.ConclusionCRA had comparable oncologic outcomes with MWA and could be a safe and effective treatment for HCC in high-risk locations.

Percutaneous Argon-Helium Cryoablation for Small Hepatocellular Carcinoma Located Adjacent to a Major Organ or Viscus: A Retrospective Study of 92 Patients at a Single Center

“…Major complications occurred in 5.4% of the 92 patients, with no procedure-related mortality. Our results are consistent with previous studies [ 9 , 26 ], and provide a further clinical reference for the application of percutaneous ablation in the treatment of HCC located adjacent to major organs or viscus.…”

Efficacy and safety of various primary treatment strategies for very early and early hepatocellular carcinoma: a network meta-analysis

“…Full-texts for 259 articles were retrieved for detailed reviews and assessments. Notably, a total of 214 records were excluded, and 45 articles [ 20 , 43 – 85 ] involving 11,364 patients were included in the final analysis. All included studies reported on overall survival outcomes for patients.…”

Thermal Ablation in the Liver: Heat versus Cold—What Is the Role of Cryoablation?

“…Regarding comparison of cryoablation to MWA, there is very little literature comparing these two modalities, and most noticeably cryoablation has not been compared with MWA in an RCT to the authors' knowledge. Hu et al 34 performed a retrospective comparison of outcomes of cryoablation (56 patients) to MWA (64 patients) for HCC and found that recurrence-free survival and OS were not significantly different between the two groups, but LTP and major complications were significantly lower in the cryoablation group ( p = 0.003 and p = 0.039, respectively). Finally, a recent meta-analysis by Gupta et al 8 compared outcomes of RFA, MWA, and cryoablation for HCC using comparative studies (randomized and non-randomized) with at least two arms comparing at least two of the three modalities.…”