Abstract
The efficacy and safety of microwave ablation (MWA) compared to radiofrequency ablation (RFA) for patients with treatment-naïve and recurrent hepatocellular carcinoma (HCC) has not been clarified in Korea. There were 150 HCC patients (100 in the RFA group and 50 in the MWA group) enrolled in our study. The primary outcome was one- and two-year disease-free survival (DFS). Secondary outcomes were complete response (CR) rate, two-year survival rate, risk factors for DFS and complication rate. Treatment outcomes were also assessed using propensity-score matching (PSM). The MWA group had better one- and two-year DFS than the RFA group (p = 0.035 and p = 0.032, respectively), whereas the CR rate, two-year survival rate, and complication rate were similar between the two groups with fewer major complications in the MWA group (p = 0.043). Patients with perivascular tumors, high risk of recurrence, and small tumor size (≤3 cm) were more suitable for MWA than RFA. MWA was also an independent factor for favorable one- and two-year DFS. Finally, the MWA group still showed better one- and two-year DFS than the RFA group after PSM. In conclusion, MWA could be an alternative treatment to RFA especially in patients with a high risk of recurrence, perivascular tumors, and small tumor size.
Highlights
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-associated mortality [1,2]
Detection of small HCC provides the chance for curative treatments such as liver transplantation, liver resection (LR), and radiofrequency ablation (RFA) [6]
disease-free survival (DFS) at one and two years was still significantly better in the microwave ablation (MWA) group than in the RFA group (p = 0.018 and p = 0.023, respectively) (Figure 4B,C). This is the first study in Korea to compare the outcomes of MWA and RFA therapy for HCC, including patients with recurrent HCC
Summary
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-associated mortality [1,2]. The poor prognosis of HCC is mainly due to late diagnosis at an advanced stage, which prohibits the application of curative therapies [3]. To improve the prognosis of HCC by diagnosing HCC at an early stage, a surveillance strategy using alpha-fetoprotein (AFP) and ultrasonography every six months is recommended for at-risk populations, including those with liver cirrhosis (LC) [4,5]. Patients with HCC are still exposed to the risk of recurrence after curative treatments.
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