Radiofrequency and Microwave Ablation in the Treatment of Hepatocelular Carcinoma

Abstract

Background: Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most common thermal ablation methods. Studies evaluating the effectiveness of these techniques have been carried out in recent years. Objectives: Evaluation of local therapeutic effectiveness of imaging guided percutaneous thermal ablation methods, short-middle term radiologic and clinical outcomes and to compare the effectiveness of treatment between two MWA and RFA methods. Patients and Methods:We retrospectively browsed clinical-radiologic-pathologic-demographic parameters of patients who had undergone RF or MW treatment due to HCC between January 2012 and January 2015. Twelve females (30%) and 28 males (70%) who had at least 6 months follow-up were included. We evaluated the risk factors which we considered to affect the prognosis by means of Log-Rank (Mantel-Cox) analysis. Complications rates, ablative effectiveness, local progression free and disease free survival rates for 6 months and 1 year periods were calculated by Kaplan Meier test for each group separately. The results of two groups were compared by chi-square test. Results: 6-month, 1-year and 2-year survival rates for thermal ablation were 84.6%, 78.7% and 65% for general; 76.3%, 55.2%, 33% for disease free and 78.9%, 76.2%, 37.3% for local progression free respectively. Size and number of lesions were the only parameters that effective for all type of survival rates. In addition, Child-Pugh classification, AFP (alpha-fetoprotein) level and gender were found to affect just; general, disease free and local progression free survival rates respectively. No statistically significant difference was found in complication, ablative effectiveness, 6 month and 1 year general, disease free and progression free survival rates between RF and MW separately. Conclusion: RF and MW ablation methods have similar complication rates, tumor ablation efficiency and survival rates for treatment in HCC patients.

Efficacy and safety of microwave ablation and radiofrequency ablation in the treatment of hepatocellular carcinoma: A systematic review and meta-analysis

“…Fifty two studies were excluded after a full-text screening. The remaining 33 studies with a total of 4589 patients (MWA = 2 044, RFA = 2 545) were included in our final analysis [13–45] (Fig. 1).…”

Thermal ablation of hepatocellular carcinoma

“…Table 1 summarizes the results of randomized control trials and cohort studies comparing percutaneous MW and RF ablation for the treatment of HCC. [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] Consequently, the current evidence is insufficient to favour MW ablation over RF ablation for HCCs smaller than 3 cm. Nonetheless, MW ablation is widely used and often preferred as a TA modality due to its ease of use, reproducibility, ability to create larger ablation volumes, and shorter procedural times.…”

“…This was probably due to studies performed more than 10 years before and to the inclusion of underpowered studies. Table 1 summarizes the results of randomized control trials and cohort studies comparing percutaneous MW and RF ablation for the treatment of HCC 63–81 …”