Abstract
PurposeTo evaluate the efficacy and safety of radiofrequency ablation (RFA) and new-generation microwave ablation (MWA) for the treatment of hepatocellular carcinoma (HCC).MethodsThe propensity score matching method was applied to patients with HCC treated with MWA (93 patients) or RFA (156 patients) at a single institution from January 2014 to April 2020. The local tumor progression (LTP), intrahepatic distant recurrence (IDR), and recurrence-free survival (RFS) of the two matched therapies were analyzed using the Kaplan–Meier method. Cox proportional hazard models were used to identify risk factors for LTP and RFS. The therapeutic effects and complications of the two treatments were also compared.ResultsThe LTP, IDR, and RFS of MWA and RFA were equivalent (LTP: hazard ratio [HR] = 0.87; 95% confidence interval [95% CI] 0.36- 2.07; P = 0.746, IDR: HR = 1.03; 95% CI 0.61–1.73; P = 0.890, RFS: HR = 1.15; 95% CI 0.69–1.91; P = 0.566). Para-vessel lesions was the only risk factor for LTP, whereas age, previous treatment, Albumin-Bilirubin score, and tumor diameter were risk factors for RFS. On the other hand, the ablation time per nodule (6.79 ± 2.73 and 9.21 ± 4.90 min; P = 0.008) and number of sessions per nodule required to achieve technical success (1.16 ± 0.39 and 1.34 ± 0.57; P = 0.009) were significantly lower in MWA than in RFA. The major complication rate of MWA and RFA was also equivalent.ConclusionMWA and RFA have similar therapeutic effects and safety, although MWA has advantages over RFA regarding efficacy, including shorter ablation time and fewer sessions required.
Highlights
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death globally, and it is estimated that both its incidence and mortality are increasing worldwide [1]
The study group included 93 patients treated with microwave ablation (MWA) and 156 patients treated with Radiofrequency ablation (RFA)
The full study cohort comprised 249 patients, including 93 patients treated with MWA and 156 patients treated with RFA
Summary
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death globally, and it is estimated that both its incidence and mortality are increasing worldwide [1]. The Barcelona Clinic Liver Cancer staging classification and treatment schedule, one of the most widely adopted liver cancer staging systems, recommends liver transplantation, resection, and ablation therapy as curative treatments for early-stage HCC [2, 3]. The Emprint Ablation SystemTM (Covidien), a microwave ablation (MWA) system with new technology, has gained increased attention [10, 11]. This new system opens up an interesting perspective as to the optimal selection of ablation modalities for local therapy for HCC. The purpose of this study was to investigate the therapeutic efficacy and safety of MWA versus RFA systems and to analyze the predictors that might influence the superiority of one system over the other
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