Abstract
PurposeTo evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC).Materials and methodsFrom June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS).ResultsThe technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test).ConclusionStereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.
Highlights
Recent advances in image diagnostic technology and the widespread use of serological tests in high-risk populations have created potential opportunities for early clinical intervention in small hepatocellular carcinoma (SHCC) [1]
The results of the present study demonstrated that the combination of transcatheter arterial chemoembolization (TACE) with DynaCT-guided Microwave ablation (MWA) could improve local tumor control in SHCC
In a recent systematic review and meta-analysis, MWA was demonstrated to be as effective as radiofrequency ablation (RFA) for HCC, and it provide superior outcomes compared with RFA in cases of larger nodules [20]
Summary
Recent advances in image diagnostic technology and the widespread use of serological tests in high-risk populations have created potential opportunities for early clinical intervention in small hepatocellular carcinoma (SHCC) [1]. Liver transplantation is still the ideal treatment for SHCC, only a small number of patients can receive this treatment [2,3,4]. In contrast to liver transplantation, surgical resection is considered to be the first-line treatment for SHCC [5,6,7]. The risk of surgical resection for SHCC with multiple hepatic lobe lesions would undoubtedly increase.
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