Percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: A long-term follow-up

• Published in: European journal of radiology Vol. 83; no. 3; pp. 552 - 558
• Main Authors: Huang, Shijia, Yu, Jie, Liang, Ping, Yu, Xiaoling, Cheng, Zhigang, Han, Zhiyu, Li, Qinying
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-03-2014
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - surgery; Catheter Ablation - adverse effects; Catheter Ablation - methods; Female; Follow-Up Studies; Hepatocellular carcinoma; Humans; Large vessels; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Male; Microwave ablation; Microwaves - therapeutic use; Middle Aged; Organs at Risk - diagnostic imaging; Percutaneous ethanol injection; Radiofrequency; Radiology; Retrospective Studies; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - methods; Treatment Outcome; Ultrasonography; Ultrasound; Veins - diagnostic imaging; Veins - injuries; Microwave ablation; Hepatocellular carcinoma; Large vessels; Radiofrequency; Ultrasound; Percutaneous ethanol injection
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2013.12.015

Abstract Purpose To retrospectively evaluate the effectiveness and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) adjacent to large vessels. Materials and methods From February 2006 to February 2013, 452 patients with 605 HCC nodules were treated with US-guided percutaneous MWA. Into large vessels group (Group L), 139 patients with 163 lesions (diameter, 1.0–7.0 cm; mean, 2.5 ± 1.1 cm) located less than 5 mm away from large vessels were enrolled. And 313 patients with 442 lesions (diameter, 1.0–8.0 cm; mean, 2.5 ± 1.2 cm) located more than 5 mm away from hepatic surface, large vessels, gallbladder and gastrointestinal tract were included in control group (Group C). During the ablation, the temperature of marginal ablation tissues was monitored and controlled. Results The median follow-up time was 24.5 months (range 2.1–87.7 months) in Group L, and 25.7 months (range 1.6–93.9 months) in Group C. Technical effectiveness was achieved in 157 of 163 (96.3%) tumors in Group L and 429 of 442 (97.1%) tumors in Group C, respectively ( p > 0.05). The 1-, 3- and 5-year local tumor progression rates and the 1-, 3- and 5-year accumulative survival rates in the two groups have no significantly statistical differences. In addition, no immediate or periprocedural major complications, no delayed complication of vessels or bile ducts injury were found in both of the two groups. Conclusions With strict temperature monitoring, US-guided percutaneous MWA is an efficient and safe technology in treating hepatocellular carcinoma adjacent to large vessels.