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

Pusceddu, Claudio; Melis, Luca; Ballicu, Nicola; Sotgia, Barbara; Melis, Marcovalerio; Sanna, Valeria; Meloni, Giovanni Battista; Porcu, Alberto; Fancellu, Alessandro

doi:10.1007/s12029-017-9951-8

Cited by 18 publications

(18 citation statements)

References 27 publications

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“…Among them, MWA can be considered a relatively new method, in which one or more microwave antennas are inserted percutaneously inside the tumor mass. The electromagnetic microwaves produce thermal energy that causes coagulative necrosis of neoplastic cells and the surrounding parenchyma (10,14,18,21). MWA offers some advantages when compared to radiofrequency ablation, which has been the most used method for ablation of nonresectable lung NSCLC (8,15,22).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous microwave ablation for large non‑small cell lung cancer: A preliminary report

et al. 2019

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The role of microwave ablation (MWA) in patients with non-small cell lung cancer (NSCLC) remains ill-defined. This retrospective study evaluated the oncological outcomes of CT-guided MWA in patients with large NSCLC. Kaplan-Meier analysis was used to evaluate overall survival (OS) and cancer-specific survival (CSS). The log-rank test was used to compare survival between patients with an NSCLC size greater or smaller than 4 cm. The likelihood of local tumor progression (LTP) was analyzed using a multivariable regression model. A total of 53 patients with 65 tumors were analyzed. The mean tumor size was 5.0±1.8 cm. At the 1-month CT scan, complete tumor ablation was observed in 44.6% of cases. In 18.5% of cases a redo-MWA session was carried out, while in 4.6%, a third MWA was necessary to obtain complete tumor necrosis. The mean follow-up was 28.1±20.6 months with a median duration of 21.5 months. The 1-year, 2-year, 3-year and 5-year OS rates were 78.2, 48.3, 34.8 and 18.3%, respectively. The median CSS was 25 months (95% CI 15.5–34.5). The 1-year, 2-year, 3-year and 5-year CSS rates were 84.3, 53.7, 42.1 and 30.0%, respectively. OS in patients with tumor size ≥4 cm was significantly lower when compared with those having smaller tumors (P=0.03). LTP was observed in 19 patients (35.8%). Incomplete tumor ablation [odds ratio (OR) 6.57; P<0.05] and tumor size ≥4 cm (OR 0.18; P<0.05) were significant independent predictors of LTP. In conclusion, CT-guided MWA may represent a useful tool in the multimodality treatment of patients with large advanced NSCLC.

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Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous microwave ablation for large non‑small cell lung cancer: A preliminary report

et al. 2019

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“…Clinical management guidelines regard RFA as an effective treatment modality for early-stage HCC [ 9 , 10 ]. RFA and microwave ablation (MWA) have been shown as a potential curative treatment modality for HCC measuring larger than 3 cm [ 11 – 14 ]. Yin et al reported that RFA or MWA achieved a complete ablation rate more than 90% with 1-, 3-, and 5-year survival rates of 75.8%, 30.9%, and 15.4%, respectively [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Yin et al reported that RFA or MWA achieved a complete ablation rate more than 90% with 1-, 3-, and 5-year survival rates of 75.8%, 30.9%, and 15.4%, respectively [ 11 ]. Pusceddu et al assessed 15 patients (33.3%) diagnosed with medium HCC measuring 3–5 cm and 13 patients (28.9%) with large HCCs measuring >5 cm who were treated with RFA, finding that complete ablation was achieved in 80% of patients with medium-sized tumors and in 53.8% of patients with large tumors (p=0.03) [ 14 ], suggesting that RFA can be extended to treat medium and large tumors. However, the complete response rate dropped to 45–70% for medium-sized HCCs (3.1–5.0 cm) and was only 23–45% for large HCCs (>5.0 cm) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation (RFA) Combined with Transcatheter Arterial Chemoembolization (TACE) for Patients with Medium-to-Large Hepatocellular Carcinoma: A Retrospective Analysis of Long-Term Outcome

Liu

Xiao

et al. 2020

Med Sci Monit

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“…Hepatocellular carcinoma (HCC) is the sixth most common malignant tumor and the third leading cause of cancer deaths worldwide [1][2][3]. Surgical management is the standard treatment for early-stage HCC; however, most patients in the intermediate and advanced stages of HCC are not surgical candidates and, are instead, managed with interventional therapies, including local ablative therapy, transarterial chemoembolization (TACE), and transarterial embolization (TAE) [4][5][6]. Computed tomography (CT)guided radiofrequency ablation (CT-RFA) of liver tumors has the advantages of minimal invasiveness, is repeatable, and is associated with fewer complications and, moreover, has become one of the most important and common clinical treatment methods for HCC in recent years [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

Huang

Zuo

et al. 2020

Abdom Radiol

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Objective To assess the clinical efficacy and safety of computed tomography-guided radiofrequency ablation(CT-RFA) combined with transarterial embolization(TAE) assisted by a three-dimensional visualization ablation planning system(3DVAPS) for hepatocellular carcinoma(HCC) in challenging locations. Methods Data from 62 treatment-naive patients with hepatocellular carcinoma(HCC), with 83 lesions in challenging locations, and who met the Milan criteria and underwent CT-RFA between June 2013 and June 2016 were reviewed. Patients were divided into one of two groups according to different treatment modalities: study group (TAE combined with RFA assisted by 3DVAPS [n = 32]); and control (RFA only [n = 30]). Oncological outcomes included ablation-related complications, local tumor progression (LTP), and overall survival (OS). Univariate and multivariate Cox proportional hazards regression analyses were performed to assess risk factors associated with LTP and OS. Results HCC lesions (mean size, 1.9 ± 1.0 mm in diameter) abutting the gastrointestinal tract (n = 25), heart and diaphragm (n = 21), major vessels (n = 13), and gallbladder (n = 3) were treated. A significant difference was detected in LTP between the two groups (P = 0.034), with no significant difference in OS between the two groups (P = 0.193). There were no severe complications related to ablation. Univariate analysis revealed that sex (P = 0.046) and child-turcotte-pugh (CTP) grade (P<0.001) were risk factors for OS, whereas CTP grade and treatment method (P<0.001) were risk factors for LTP. Multivariate analysis revealed that CTP grade B (P = 0.005) was independently associated with poor OS, and RFA alone (P<0.001) was independently associated with poor LTP. Conclusion CT-RFA combined with TAE assisted by a 3DVAPS provided ideal clinical efficiency for HCC in challenging locations and was a highly safe treatment modality.

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

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

Cited by 18 publications

References 27 publications

Usefulness of percutaneous microwave ablation for large non‑small cell lung cancer: A preliminary report

Usefulness of percutaneous microwave ablation for large non‑small cell lung cancer: A preliminary report

Radiofrequency Ablation (RFA) Combined with Transcatheter Arterial Chemoembolization (TACE) for Patients with Medium-to-Large Hepatocellular Carcinoma: A Retrospective Analysis of Long-Term Outcome

Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

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