Abstract No. 157 Computed tomography–guided percutaneous microwave ablation as bridging therapy for patients with hepatocellular carcinoma awaiting liver transplant: a single-center experience

Abstract

Our objective was to determine the pathologic response of computed tomography (CT)–guided percutaneous microwave ablation as bridging therapy for patients with hepatocellular carcinoma awaiting liver transplant. A single-center retrospective analysis was conducted of 78 patients (M:F = 67:13) with mean age of 58.9 years ± 14 months (SD) with 78 hepatocellular carcinoma within Milan criteria that were treated with percutaneous MWA as bridging therapy and subsequent orthotopic liver transplant between August 2014 and September 2018. The pathology reports of the explanted livers were reviewed to assess for residual disease. Residual disease was categorized as complete or incomplete necrosis. Patient demographics, tumor/procedural characteristics, and laboratory values were evaluated. Survival from time of ablation and time of transplant were recorded and compared between cohorts using log rank tests. Median time to liver transplant post-MWA was 10.9 months (7.4 - 14.1 months) (IQR). The mean tumor size was 2.45 cm ± .76 cm (SD), (range = 0.9-4.6 cm). The median survival from ablation was 56.7 (IQR = 72.2—42.9 months), and the median survival from transplant was 44.7 months (IQR = 59.0—32.6 months). Complete necrosis in 61% of cases. There was no significant difference in survival for patients with complete (P = 0.40) versus incomplete necrosis (P = 0.71). There was no significant difference in survival from orthotopic liver transplant between patients with macroscopically (P = 0.37) or microscopically (P = 0.68) evident disease. CT-guided percutaneous microwave ablation is effective in achieving complete necrosis for patients with hepatocellular carcinoma who are awaiting orthotopic liver transplant.