Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma |
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| Authors: | Yun Xu Qiang Shen Neng Wang Pan-Pan Wu Bin Huang Ming Kuang Guo-Jun Qian |
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| Institution: | 1. Department of Minimal Invasion Therapy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University of Chinese PLA, 225# Changhai Rd, Shanghai 200438, P. R. China;2. Department of Radiology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University of Chi-nese PLA, Shanghai 200438, P. R. China;3. Division of Interventional Ultrasound, Department Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2nd, Guangzhou 510080, Guangdong, P. R. China |
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| Abstract: | Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease. |
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| Keywords: | Microwave ablation Radiofrequency ablation Hepatocellular carcinoma |
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