Comparison of percutaneous microwave ablation and surgical resection for hepatocellular carcinoma in the caudate lobe.

Abstract

This study aims to compare the clinical efficacy and safety between ultrasound (US)-guided percutaneous microwave ablation (MWA) assisted with a three-dimensional (3D) visualization preoperative planning system and surgical resection (SR) for hepatocellular carcinoma (HCC) in the caudate lobe. Forty-nine patients diagnosed with caudate lobe HCC, who underwent US-guided percutaneous MWA (29 patients) or SR (20 patients), were enrolled between November 2005 and December 2018. Follow-up was performed at 1, 3, 6, 12, 18, 24, and 36 months after ablation or resection. The follow-up endpoint was recurrence or patient death. Overall survival (OS) and progression-free survival (PFS) were the primary outcomes, whereas local tumor progression (LTP), intrahepatic recurrence, and extrahepatic metastasis were the secondary ones. The mean age of the two groups was 61.4 ± 9.1 (MWA) and 53.1 ± 6.8 (SR), respectively, with a significant difference (P < 0.01). There were no significant differences in OS (69.0% in the MWA group and 75.0% in the SR group) and PFS (62.1% in the MWA group and 35.3% in the SR group). LTP, intrahepatic recurrence, and extrahepatic recurrence were 6.9% (2/29), 31.0% (9/29), and 20.7% (6/29) in the MWA group and 5.0% (1/20), 60.0% (12/20), and 5.0% (1/20) in the SR group. The MWA group was more cost-effective and required less hospitalization time. No major complications were observed. US-guided percutaneous MWA for HCC in the caudate lobe assisted with a 3D visualization preoperative planning system is an optional treatment with less expenses and shorter hospitalization than SR.