Hepatic resection versus microwave ablation for the treatment of early hepatocellular carcinoma: a comparative analysis of treatment outcomes and survival predictors

Hepatic resection versus microwave ablation for the treatment of early hepatocellular carcinoma: a comparative analysis of treatment outcomes and survival predictors

Introduction Liver resection and local ablation are the two primary curative treatments for early-stage hepatocellular carcinoma (HCC). Microwave ablation (MWA) shows promising performance in terms of early tumor response, recurrence, and survival. This study aims to determine whether MWA would be c...

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Bibliographic Details
Published in:Egyptian Liver Journal Vol. 12; no. 1; pp. 1 - 11
Main Authors: Osman, Ayman M. A, Abdelaziz, Ashraf Omar, Deweir, Mahmoud, Salah, Ayman, Harb, Shady Tarek Elghazaly, Nabeel, Mohamed Mahmoud, Abdelmaksoud, Ahmed Hosni
Format: Journal Article
Language:English
Published: Springer 01-12-2022
SpringerOpen
Subjects:
Ablation (Surgery)
Care and treatment
Comparative analysis
Development and progression
Hepatitis C
Hepatocellular carcinoma
Hepatoma
Liver
Liver resection
Medical research
Medicine, Experimental
Microwave ablation
Patient outcomes
Recurrence
Surgery
Survival
Egypt
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Summary:Introduction Liver resection and local ablation are the two primary curative treatments for early-stage hepatocellular carcinoma (HCC). Microwave ablation (MWA) shows promising performance in terms of early tumor response, recurrence, and survival. This study aims to determine whether MWA would be comparable to liver resection in treating early-stage HCC. Methods This study included patients with hepatitis C-related HCC attending the multidisciplinary HCC clinic, Kasr Al-Ainy Hospital (March 2018 to September 2020). We included adults with early-stage HCC (BCLC stages 0-A). We studied patients and tumor characteristics, HCC treatment response, recurrence, and overall survival. Results Thirty-one patients were treated with liver resection and 41 patients were treated with MWA, including 4 patients who received intraoperative MWA. By the end of the study, 21 patients (28.77%) died. Patients who underwent MWA were younger compared to the hepatectomy group with lower baseline AFP (21 (6.7-54) versus 77 (31.3-136.0), respectively, (P value 0.024) and tumor size (2.78 (0.87) cm versus 3.77 (0.97) cm, respectively, (P value < 0.001). We found no differences between the studied groups in terms of treatment response, post-treatment decompensation, recurrence, or overall survival. One-year survival probability in the MWA and resection groups was 75.5% and 76.3% respectively. Post-procedure hepatic decompensation was the only independent predictor of lower survival by multivariate logistic regression analysis (OR 37.74, 95%CI 6.251-227.87, P value < 0.001) after adjusting for age, AFP, and tumor size. Conclusion Liver resection and MWA showed similar satisfactory results in the treatment of early-stage HCC, in terms of treatment response, recurrence, and overall survival.
ISSN:2090-6218
2090-6226
DOI:10.1186/s43066-022-00210-2