Comparisons of recurrence-free survival and overall survival between microwave versus radiofrequency ablation treatment for hepatocellular carcinoma: A multiple centers retrospective cohort study with propensity score matching.

Shibin Du,Jing Chen,Yan-Yan Sun,Jian-Zhi Yang,Wei-Gang Zhou,Scott M Langevin

doi:10.1371/journal.pone.0227242

Shibin Du, Jing Chen + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0227242

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Abstract

Both microwave (MW) ablation and radiofrequency (RF) ablation are widely used for hepatocellular carcinoma (HCC) treatments in clinic. However, it is still unclear if ablative methods could influence the recurrence-free survival (RFS) and overall survival (OS) of HCC patients. Therefore, we carried out this multi-center retrospective cohort study to investigate the differences of recurrence-free survival (RFS) and overall survival (OS) between MW ablation and RF ablation by survival analysis. From January 2014 to December 2016, patients who received thermal ablation surgery for HCC treatment were screened. Finally, 452 patients met the eligibility criteria and finished the follow-up. Univariable and multivariable regression analyses were used to identify independent predictive factors of the RFS and OS. Also, propensity score matching (PSM) was used to balance the bias between two groups. Finally, we found that before the PSM, the univariable and multivariable regression analyses revealed that there were no significant differences on the RFS between two groups. Same results were obtained for the OS. After PSM, 115 pairs of patients were created, and both the univariable and multivariable regression analyses suggested that there were still no significant differences on the RFS between two groups. Same results were obtained for the OS. In conclusion, our present study showed that there were no significant differences between MW ablation and RF ablation for HCC patients on the RFS or OS.

Highlights

Introduction and backgroundHepatocellular carcinoma (HCC) is the fifth most common malignant tumor and the third leading cause of cancer-related death worldwide [1,2]
Same conclusion could be affirmed again for the overall survival (OS) rates between MW ablation and RF ablation groups (Table 8 and Fig 2B). According to this multi-center retrospective cohort study, we found that there were no significant differences between MW ablation and RF ablation for hepatocellular carcinoma (HCC) patients on the recurrence-free survival (RFS) or OS
Though liver resection is the first-line curative treatment for patients with HCC, several studies had verified that hepatic resection contributed to a higher rate of complications and surgical mortality [20,21]

Summary

Introduction and background

Hepatocellular carcinoma (HCC) is the fifth most common malignant tumor and the third leading cause of cancer-related death worldwide [1,2]. In China, HCC is the third incidence rate and mortality rate for all cancers [4]. A prospective study involved 111 patients who received MW ablation or RF ablation suggested that a lower incidence of local recurrence was observed in microwave group [11]. A meta-analysis which involved 2062 patients showed that MW ablation and RF ablation had similar 1–5-year overall survival, disease-free survival, local recurrence rate, and adverse events [12]. It is currently unclear and lack of rigorous proof to recommend one ablative method. We hypothesize that there are no significant differences between MW ablation and RF ablation for HCC patients’ prognosis

Patients and methods

Result

Anesthetic methods

Discussion

Findings

Ablation methods