Percutaneous microwave ablation for liver cancer adjacent to the diaphragm

Abstract

Purpose: The aim of the study was to prospectively evaluate the safety and effectiveness of percutaneous microwave (MW) ablation for liver cancer adjacent to the diaphragm.Materials and methods: From May 2005 to June 2008, 89 patients with 96 hepatic lesions adjacent to the diaphragm (the shortest distance from the lesion margin to the diaphragm less than 5 mm), who underwent ultrasound (US)-guided percutaneous MW ablation, were included in the study group. A total of 100 patients with 127 hepatic lesions not adjacent to the diaphragm (the shortest distance from the lesion to the diaphragm and the first or second branch of the hepatic vessels more than 10 mm), who underwent US-guided percutaneous MW ablation, were included in the control group. During the ablation the temperature of marginal ablation tissue proximal to the diaphragm was monitored and controlled at 50°–60°C for more than 10 min in the study group. We compared the results of ablation between the two groups.Results: A total of 91 of 96 tumours (94.8%) in the study group and 123 of 127 tumours (96.9%) in the control group achieved complete ablation (P > 0.05). Local tumour progression was found in 18 of 96 tumours (18.8%) in the study group and 21 of 127 tumours (16.5%) in the control group during follow-up after MW ablation (P > 0.05). No major complications occurred in either group.Conclusions: Under strict temperature monitoring, percutaneous MW ablation is safe and can achieve a high complete ablation rate for the treatment of hepatic tumours adjacent to the diaphragm.