Percutaneous microwave ablation of 5-6 cm unresectable hepatocellular carcinoma: local efficacy and long-term outcomes

Abstract

MWA is safe and effective for the treatment of selected large HCCs, and provides an alternative treatment option for patients with unresectable HCCs. Furthermore, the favourable local efficacy of MWA could potentially improve long-term survival.

Comparison of the Efficacy and Prognostic Factors of Transarterial Chemoembolization Plus Microwave Ablation versus Transarterial Chemoembolization Alone in Patients with a Large Solitary or Multinodular Hepatocellular Carcinomas

“…One such strategy is TACE plus MWA. Previous studies reported that TACE plus MWA is much more effective than conventional TACE in patients with large solitary HCCs ( 12 13 ). However, to the best of our knowledge, no study has yet analyzed outcomes after TACE plus MWA in patients with large solitary and multinodular (not more than 10 tumors) HCCs.…”

Computed tomography-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: safety and efficacy of high-power microwave platforms

“…According to systematic reviews and meta-analysis, percutaneous radiofrequency and microwave ablation demonstrated similar efficacy for the treatment of HCC, but with an apparent superiority of MWA in larger neoplasms [32]. The superiority of microwave ablation in large diameter HCC is reported in most literature studies [33][34][35]. Moreover, various studies comparing the specific microwave system used in the present study to low-frequency microwave generators reported significantly higher ablation volumes, longer time to progression and lower progression rates for high-power/ high-frequency systems [36].…”

Percutaneous microwave ablation applications for liver tumors: recommendations for COVID-19 patients

“…As it is shown in the results, large tumors (tumor diameter >50 mm) have less chance of success and more chance of recurrence compared to smaller ones. In another study which was focused on MWA of large HCC tumors (5–6 cm) in 82 patients, local efficacy and long-term outcomes were investigated [ 48 ]. A Qinghai FORSEA MWA system with a 14-gauge cooled shaft antenna was used in this study.…”

“…As seen throughout these studies and mentioned previously, tumors < 3cm appear to have the best rates for overall survival. Recommended tumor classification for MWA treatment can be given by ECOG level (0–2), Barcelona Clinic Liver Cancer (BCLA 0 to A), and/or Child-Pugh score (A to B) [ 47 , 48 , 49 , 88 ]. Depending on tumor location (within the tumor or on the surface), MWA would be preferable, but not limited, to tumors buried within the liver [ 91 ].…”

“…Some other non-thermal therapy techniques, such as external beam radiation therapy (EBRT) and proton beam therapy (PBT), use ionizing radiation [ 44 , 45 , 46 ]. They can be effective treatments, however, as a comparison, the average OS rate after 1 year follow up for 770 HCC patients treated with MWA from the data in this review (from small to large tumors) was 88% [ 47 , 48 , 49 , 50 ]; whereas the average 1-year OS rate for EBRT among 1051 patients was 83% [ 45 ]. In a study on 162 HCC patients treated with PBT, the average 1-year OS rate was 79% [ 51 ].…”