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

Abstract

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

Rhein‐based necrosis‐avid MRI contrast agents for early evaluation of tumor response to microwave ablation therapy

“…Thermal ablation techniques [1][2][3] including radiofrequency ablation, microwave ablation (MWA), and high-intensity focused ultrasound with less invasiveness, wider patient population, better preservation of surrounding normal tissues, lower cost, and shorter hospitalization times as compared to conventional surgical resection-have been playing a predominant part in the treatment of early hepatocellular carcinoma. 1,4,5 However, it is reported that the local recurrence occurs in 40% to 60% cases of thermal ablation, [6][7][8] mainly caused by residual tumor cells that escaped from the initial ablation.…”

Microwave ablation combined with chemotherapy improved progression free survival of IV stage lung adenocarcinoma patients compared with chemotherapy alone

“…Microwave ablation (MWA) has recently been applied as topical therapy for lung cancer patients and has been shown to enlarge ablative regions and shorten the treatment time when compared with RFA . In this study, we evaluate whether MWA combined with chemotherapy could improve PFS of patients with stage IV lung adenocarcinoma compared with chemotherapy alone.…”

Safety and effective of laparoscopic microwave ablation for giant hepatic hemangioma: A retrospective cohort study

“…Percutaneous radiofrequency ablation therapy was considered as a minimally invasive and safe treatment for malignant neoplasms of the liver, but it has limitations for lesions near the diaphragm or in the periphery of the liver, which may result in damage to adjacent organs [17]. Microwave ablation offers all the benefits of radiofrequency ablation and some additional advantages, including reduced procedure time and decreased heat-sink effect [18]. Therefore, microwave ablation should be considered as highly effective treatment for huge hepatic hemangioma.…”