Image-Guided Percutaneous Microwave Ablation Versus Cryoablation For Hepatocellular Carcinoma In High-Risk Locations: Intermediate-Term Results
Authors Hu J, Chen S, Wang X, Lin N, Yang J, Wu S
Received 20 August 2019
Accepted for publication 25 October 2019
Published 18 November 2019 Volume 2019:11 Pages 9801—9811
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Dr Teng
Jiahui Hu,1 Sheng Chen,2 Xin Wang,3 Ning Lin,2 Jianchuan Yang,2 Songsong Wu2
1Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, People’s Republic of China; 2Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, People’s Republic of China; 3Department of Oncology, Fuzhou Hospital of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350001, People’s Republic of China
Correspondence: Songsong Wu
Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, People’s Republic of China
Objective: The aims of this study were to compare the clinical outcomes between image-guided percutaneous microwave ablation (MWA) and cryoablation (CRA) in patients with hepatocellular carcinoma (HCC) in high-risk locations and to identify the prognostic factors associated with the two treatment methods.
Methods: This retrospective study was institutional review board approved. A total of 120 patients (88 men and 32 women) with one hundred and thirty-four HCC lesions in high-risk locations from April 2014 to March 2018 were reviewed. Sixty-four patients underwent MWA and 56 patients underwent CRA. Survival, recurrence and complications were compared between the two groups. Effect of changes in key outcomes (i.e., overall survival (OS), recurrence-free survival (RFS) and local tumor progression (LTP)) was statistically analyzed with the log rank test. Univariate and multivariate analysis were performed on clinicopathological variables to identify factors affecting intermediate-term outcomes.
Results: The OS and RFS after MWA were comparable to those of CRA (P =0.141, and P=0.469, respectively). The LTP and major complication in MWA group was higher than those in CRA group (P=0.003, and P=0.039). Univariate analysis showed that age (P=0.007), tumor size (P=0.001), and Child-Turcotte-Pugh (CTP) grade (P=0.003) were risk factors for OS, and multivariate analysis results showed that older age (≥65 years) (P=0.002, HR:3.338, 95% CI:1.928–5.281), 3.0–5.0 cm in size (P<0.001, HR: 3.312, 95% CI: 1.872–4.489) and CTP grade B (P=0.001, HR:3.382, 95% CI: 1.882–5.902) were independently associated with poor OS.
Conclusion: CRA had comparable oncologic outcomes with MWA and could be a safe and effective treatment for HCC in high-risk locations.
Keywords: hepatocellular carcinoma, microwave ablation, cryoablation, outcome, high-risk
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