Journal Article

Oncological Outcomes of Operative Microwave Ablation for Intermediate Stage Hepatocellular Carcinoma: Experience in 246 Consecutive Patients

Yuko Takami, Yoshiyuki Wada, Hideki Saitsu, Tomoki Ryu

2022

Overview

Background Few clinical studies concerning the efficacy of microwave ablation for intermediate stage hepatocellular carcinoma have been published. Our purpose was to examine perioperative and long-term outcomes after operative microwave ablation for intermediate stage hepatocellular carcinoma. Methods This retrospective study included 246 patients who had undergone operative microwave ablation for intermediate stage hepatocellular carcinoma in our institute between January 2001 and December 2017. We analyzed overall and recurrence-free survival and used the Cox proportional hazard model to evaluate potential prognostic factors. Results The overall median follow-up time was 51 months. The 1-, 3-, 5-, and 10-year overall survival rates were 98%, 74%, 51%, and 28%, respectively, whereas the 1-, 3-, 5-, and 10-year recurrence-free survival rates were 80%, 32%, 18%, and 10%, respectively. The major complication rate (Clavien–Dindo classification IIIa or above) after operative microwave ablation was 7%, with no procedure-related mortality. Multivariate analysis identified beyond up-to-7 criteria (the sum of the largest tumor’s diameter in cm and the total number of tumors), Child–Pugh grade B, and serum alpha-fetoprotein concentration ≥ 100 ng/mL as independent risk factors for overall survival after operative microwave ablation. The overall survival of patients within up-to-7 and Child–Pugh grade A was better than that of the remaining patients, 5-year overall survivals being 67% and 37%, respectively ( P  < 0.001). Conclusions Operative microwave ablation is safe and effective in patients with intermediate stage hepatocellular carcinoma. In particular, patients within up-to-7 and Child–Pugh grade A can be expected to have better long-term outcomes after operative microwave ablation.

• Publisher: Elsevier BV,Springer US,Springer Nature B.V
• Subject: Ablation / Asymptomatic / Carcinoma, Hepatocellular / Carcinoma, Hepatocellular - pathology / Catheter Ablation / Gastroenterology / Gastrointestinal surgery / Hepatitis / Humans / Liver cancer / Liver Neoplasms / Liver Neoplasms - pathology / Magnetic resonance imaging / Medical prognosis / Medicine / Medicine & Public Health / Microwaves / Microwaves - therapeutic use / Mortality / Neoplasm Recurrence, Local / Neoplasm Recurrence, Local - surgery / Original Article / Patients / Retrospective Studies / Surgery / Tomography / Treatment Outcome / Tumors / Ultrasonic imaging