Ultrasound-guided microwave ablation in the individualized treatment of hepatocellular carcinoma adjacent to danger areas

Abstract

Objectives To investigate the efficiency and safety of ultrasound-guided microwave ablation (MWA) for hepatocellular carcinoma (HCC) adjacent to danger areas. Methods The 106 patients with HCC treated by ultrasound-guided MWA were retrospectively included in our study. There were 149 lesions in total, including 8 lesions adjacent to gallbladder, 33 lesions adjacent to grade Ⅰ-Ⅱ bile duct, 39 lesions adjacent to diaphragm, 28 lesions adjacent to gastrointestinal tract and 41 lesions adjacent to hepatic capsule. The mean diameter of the tumors was (2.04±0.92)cm. Individualized treament strategies for different sites of the tumors were conducted. The early complete ablation rate of the tumors was assessed by enhanced computed tomography (CT) or magnetic resonance imaging (MRI) one month later and followed up regularly. Results The total inactivation rate was 89.9%. The early complete ablation rates of adjacent gallbladder, adjacent grade Ⅰ-Ⅱ bile duct, adjacent diaphragm, adjacent gastrointestinal tract and adjacent hepatic capsule were 100%, 84.8%, 89.7%, 92.9%, 90.2% respectively. The local progression rates were 0, 15.2%, 10.3%, 7.1%, 9.8%, respectively. The 1-, 2- and 3-year survival rates were 91.6%, 85.8% and 74.5%. Total cases were ablated 149 times. Serious complications accounted for 6.6%, including diaphragm injury, needle implantation, abdominal hemorrhage, severe infection, bile tumors. Conclusions Our study presented a novel individualized treament strategies using MWA in HCC patients. The individualized scheme effectively boosted the complete ablation rate of tumors and significantly improve the clinical outcome of HCC patients. Key words: Ultrasonography; Microwaves; Ablation techniques; Liver neoplasms