Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Thornton, L.; Cabrera, Roniel; Kapp, M.; Lazarowicz, Michael; Vogel, Jeffrey D.; Toskich, Beau B.

doi:10.1067/j.cpradiol.2017.02.006

Cited by 21 publications

(19 citation statements)

References 28 publications

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“…Durability of response, defined as local disease control for the duration of the study, demonstrated a significant difference in favor of MWA. There was no statistical difference in complication rates (3% vs. 2%) . In contrast to Thornton et al , Vasnani also compared the efficacy of RFA and MWA in combination with transarterial chemoembolization (DEB‐TACE), demonstrating that both RFA and MWA in sequential combination with DEB‐TACE are equally efficacious at inducing HCC tumor coagulation .…”

Section: Discussionmentioning

confidence: 92%

“…The technological progress (“mini‐choke”) permits researchers to obtain a larger diameter of necrosis area more quickly than with RFA . Thornton et al compared the initial response, local recurrence, and complication rates of RFA versus MWA when combined with neoadjuvant bland transarterial embolization (TAE) or drug‐eluting microsphere chemoembolization (TACE) for the treatment of HCC . Thirty‐five patients with HCC with Barcelona Clinic Liver Cancer (BCLC) very early and early stage (range, 1.2–4.1 cm) underwent TAE (23), TACE (12), RFA (15), or MWA (20).…”

Section: Discussionmentioning

confidence: 99%

“…There was no statistical difference in complication rates (3% vs. 2%) . In contrast to Thornton et al , Vasnani also compared the efficacy of RFA and MWA in combination with transarterial chemoembolization (DEB‐TACE), demonstrating that both RFA and MWA in sequential combination with DEB‐TACE are equally efficacious at inducing HCC tumor coagulation . The authors assessed 42 patients who underwent combined therapy: 11 tumors (2.9 cm; range, 1.8–4.3) treated with DEB‐TACE/RFA and 40 tumors (mean, 2.4 cm; range, 1.1–5.4) with DEB‐TACE/MWA.…”

Section: Discussionmentioning

confidence: 99%

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Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update

et al. 2019

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This article provides an overview of radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of primary liver tumors and hepatic metastasis. Only studies reporting RFA and MWA safety and efficacy on liver were retained. We found 40 clinical studies that satisfied the inclusion criteria. RFA has become an established treatment modality because of its efficacy, reproducibility, low complication rates, and availability. MWA has several advantages over RFA, which may make it more attractive to treat hepatic tumors. According to the literature, the overall survival, local recurrence, complication rates, disease‐free survival, and mortality in patients with hepatocellular carcinoma (HCC) treated with RFA vary between 53.2 ± 3.0 months and 66 months, between 59.8% and 63.1%, between 2% and 10.5%, between 22.0 ± 2.6 months and 39 months, and between 0% and 1.2%, respectively. According to the literature, overall survival, local recurrence, complication rates, disease‐free survival, and mortality in patients with HCC treated with MWA (compared with RFA) vary between 22 months for focal lesion >3 cm (vs. 21 months) and 50 months for focal lesion ≤3 cm (vs. 27 months), between 5% (vs. 46.6%) and 17.8% (vs. 18.2%), between 2.2% (vs. 0%) and 61.5% (vs. 45.4%), between 14 months (vs. 10.5 months) and 22 months (vs. no data reported), and between 0% (vs. 0%) and 15% (vs. 36%), respectively. According to the literature, the overall survival, local recurrence, complication rates, and mortality in liver metastases patients treated with RFA (vs. MWA) are not statistically different for both the survival times from primary tumor diagnosis and survival times from ablation, between 10% (vs. 6%) and 35.7% (vs. 39.6), between 1.1% (vs. 3.1%) and 24% (vs. 27%), and between 0% (vs. 0%) and 2% (vs. 0.3%). MWA should be considered the technique of choice in selected patients, when the tumor is ≥3 cm in diameter or is close to large vessels, independent of its size. Implications for Practice Although technical features of the radiofrequency ablation (RFA) and microwave ablation (MWA) are similar, the differences arise from the physical phenomenon used to generate heat. RFA has become an established treatment modality because of its efficacy, reproducibility, low complication rates, and availability. MWA has several advantages over RFA, which may make it more attractive than RFA to treat hepatic tumors. The benefits of MWA are an improved convection profile, higher constant intratumoral temperatures, faster ablation times, and the ability to use multiple probes to treat multiple lesions simultaneously. MWA should be considered the technique of choice when the tumor is ≥3 cm in diameter or is close to large vessels, independent of its size.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update

et al. 2019

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“…After a preliminary review, 418 papers were excluded because they were considered irrelevant studies, case reports, animal studies, comment letters, or reviews. Among 32 potentially relevant papers, we excluded five studies in which patients were treated with embolization combined with MWA or RFA [12][13][14][15][16] and another seven because of insufficient data [17][18][19][20][21][22][23]. Six studies were excluded because of duplicate data [24][25][26][27][28][29].…”

Section: Statistical Analysesmentioning

confidence: 99%

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

Tan

Deng

Lin

et al. 2019

International Journal of Hyperthermia

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Background: Microwave ablation (MWA) has several advantages over radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). We aimed to compare the efficacy and safety of MWA with those of RFA for HCC from the perspectives of percutaneous and laparoscopic approaches. Methods: PubMed/MEDLINE, Embase, the Cochrane library, and China Biology Medicine databases were searched. Studies comparing the efficacy and safety of MWA with those of RFA in patients with HCC were considered eligible. Complete ablation (CA), local recurrence (LR), disease-free survival (DFS), overall survival (OS), and the major complication rate were compared between MWA and RFA. Results: Four randomized controlled trials and 10 cohort studies were included. For percutaneous ablation, no significant difference was found between MWA and RFA regarding CA, LR, DFS, OS, and the major complication rate. A subgroup analysis of tumors measuring !3 cm revealed no difference in CA and LR for percutaneous ablation. For laparoscopic ablation, a significantly lower LR rate and a non-significant trend toward a higher major complication rate were observed for the MWA group (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.16-4.02, p ¼ .01 for LR; OR 0.21, 95% CI 0.04-1.03, p ¼ .05 for major complication rate). CA, DFS, and OS were similar between the two groups. Conclusions: Percutaneous (P)-MWA had similar therapeutic effects compared with P-RFA for HCC. Patients undergoing laparoscopic MWA had a lower LR rate; however, their major complication rate appeared to be higher. The superiority of MWA over RFA remains unclear and needs to be confirmed by high-quality evidence.

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“…We decided to adopt microwave ablation combined with TAE treatment. The safety and e cacy of microwave ablation combined with TAE treatment is better than those of ablation alone [14] . The reasons are as follows: (1) TAE can effectively reduce the blood supply in the tumor by embolizing the blood vessels of the hemangioma, which can reduce the heat taken away by the "heat sedimentation effect" caused by the rich blood ow during the ablation process, resulting in a large microwave ablation treatment e ciency; (2) after TAE blocks the artery supplying the hemangioma, it can effectively reduce the risk of intraoperative bleeding; and (3) the application of iodized oil to the tumor in the TAE procedure can further de ne the hemangioma boundary and accurately locate it to avoid damage to the surrounding organs [15] .…”

Section: Discussionmentioning

confidence: 99%

TAE Combined with Microwave Ablation in the Treatment of Rare Giant Hepatic Hemangioma:Case Report and Literature Review

Feng¹,

Chen²,

Mo³

et al. 2020

Preprint

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Background: hepatic hemangioma is the most common benign tumor of the liver. However, patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention. It is necessary to explore additional minimally invasive and personalized treatment options.Case presentation: A 47-year-old female was diagnosed with right hepatic hemangioma for more than 10 years. Abdominal contrast-enhanced CT and CEUS revealed that there was a large hemangioma in the right liver, with a size of approximately 95x97x117 mm. Due to the patient's refusal of surgical treatment, hepatic artery embolization was performed in the first stage, then after 25 days of liver protection treatment, the liver function indexes decreased to normal levels. Then, B-ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed. Ten days after the surgery, hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size (the volume was reduced by approximately 30%). Then the patient was discharged from the hospital, and CT suggested that the hepatic hemangioma is significantly smaller two months after discharge. Because of COVID-19, the patient's CT examination was delayed.Conclusions: TAE combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.

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Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Cited by 21 publications

References 28 publications

Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update

Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

TAE Combined with Microwave Ablation in the Treatment of Rare Giant Hepatic Hemangioma:Case Report and Literature Review

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