Abstract
Sclerosing hepatic carcinoma (SHC) is a rare subtype of hepatic carcinoma that can be caused by various pathogeneses. The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation; thus, surgical resection represents the primary option for the majority of patients. However, a small proportion of patients who cannot withstand surgery or who have inoperable tumors may not receive adequate treatment, causing the progression of cancer and related high mortality. To overcome the high puncture resistance, high thermal resistance, and poor thermal conductivity of microwave ablation, we developed percutaneous no-touch multiple-site microwave ablation (NTMSWA) to ablate SHC lesions. In this retrospective study, 96 and 41 patients underwent NTMSWA and surgery, respectively. In the NTMSWA group, tumor size and histological classification were determined by medical imaging and tissue biopsy before ablation, and then a personalized ablation regimen was performed. Complete ablation was achieved in a single session in 81 out of 96 (84.4%) patients. The median survival (MS) of the 90 patients who underwent NTMSWA was 51 months, and the overall survival (OS) rate at 5 years was 49.1%. In contrast, the MS in the control group was 57 months, and the OS rate at 5 years was 56.3%. There was no significant difference between the two groups, indicating that SHC <50 mm in size can be effectively ablated with NTMSWA. By adopting no-touch, multiple-site, low-power, intermittent ablation, SHC less than 50 mm in size can be completely ablated.
Highlights
Sclerosing hepatic carcinoma (SHC) is a subtype of hepatic carcinoma (HC), accounting for less than 5% of total HC cases
The average ablation scope increased as the ablation power/time increased (Table 1). e investigation could assist us in determining the ideal ablation power, sites, and time while reducing normal tissue damage and improving the therapeutic ratio
Discussion e morbidity of rare SHC readily increases due to the widespread practice of liver cancer screening among patients with chronic hepatitis B and/or hepatocirrhosis [10, 11]
Summary
Sclerosing hepatic carcinoma (SHC) is a subtype of hepatic carcinoma (HC), accounting for less than 5% of total HC cases. It can be caused by the increased proliferation of fibroblasts/ myofibroblasts and fibrosis in its tumor microenvironment [1]. Patients who cannot withstand surgery may have to seek other therapeutics, such as conventional chemotherapy, transcatheter arterial embolization, and thermal ablation [4]. SHC is difficult to treat with chemotherapy and embolization because of its inherent resistance to chemotherapy, fibrosis, and relatively poor blood supply [4].
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