Microwave ablation provided better overall survival than liver resection for small hepatocellular carcinoma in patients with borderline liver function

Abstract

Background: Microwave ablation (MWA) is showed to be at least as effective as, if not superior than, radiofrequency ablation in treating HCC. Studies comparing MWA and liver resection are lacking. The aim of this study is to evaluate the survival of patients who were treated with liver resection and MWA and to evaluate if the newly developed Albumin-Bilirubin (ALBI) grade can help in patient selections for liver resection or ablation. Methods: This is a retrospective analysis on patients who received curative liver resection and MWA for primary HCC from March 2009 to December 2015. Baseline clinical and laboratory parameters were retrieved and reviewed from the hospital database. Propensity score matching was used at 1:1 ratio. The ALBI grade was evaluated for their abilities of patient selection. Results: A total of 442 patients underwent MWA and liver resection for primary HCC during the study period. Propensity scoring matching was used and resulted in 63 matched pairs for further analysis. While liver resection still offered better overall and disease-free survivals in patients with ALBI grade 1, MWA provided a significantly better overall survival in patients with ALBI grade 2 or 3. (p=0.025) Conclusion: Microwave ablation, as a treatment for HCC, offered superior overall survival to liver resection in patients ALBI grade 2 or 3.