Highlights
- •We reviewed 145 cases to compare the efficacy of percutaneous radiofrequency and microwave ablation for treating HCC.
- •There was no overall difference efficacy between the microwave and radiofrequency ablation for the treatment of HC
- •Microwave ablation procedures combined with same-day biopsy were associated with increased risk of primary failure.
- •HCC that were located adjacent to other organs and were treated with MW ablation were at higher risk of local progression.
Abstract
Purpose
To compare percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA)
for treatment of Hepatocellular carcinoma (HCC) and to identify risk factors for treatment
failure and local progression.
Methods
145 unique HCC [87 (60%) RFA, 58 (40%) MWA] were retrospectively reviewed from a single
tertiary medical center. Adverse events were classified as severe, moderate, or mild
according to the Society of Interventional Radiology Adverse Event Classification system. Primary and secondary efficacy, as well as local
progression, were determined using mRECIST. Predictors of treatment failure and time
to local progression were analyzed using generalized estimating equations and Cox
regression, respectively.
Results
Technical success was achieved in 143/145 (99%) HCC. There were 1 (0.7%) severe and
2 (1.4%) moderate adverse events. Of the 143 technically successful initial treatments,
136 (95%) completed at least one follow-up exam. Primary efficacy was achieved in
114/136 (84%). 9/22 (41%) primary failures underwent successful repeat ablation, so
secondary efficacy was achieved in 128/136 (90%) HCC. Local progression occurred in
24 (19%) HCC at a median of 25 months (95% CI = 19–32 months). There was no difference
in technical success, primary efficacy, or time to local progression between RFA and
MWA. In HCC treated with MWA, same-day biopsy was associated with primary failure
(RR = 9.0, 95% CI: 1.7–47, P = 0.015), and proximity to the diaphragm or gastrointestinal tract was associated
with local progression (HR = 2.40, 95% CI:1.5–80, P = 0.017).
Conclusion
There was no significant difference in primary efficacy or time to local progression
between percutaneous RFA and MWA.
Keywords
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Article info
Publication history
Published online: June 19, 2020
Accepted:
June 7,
2020
Received in revised form:
April 19,
2020
Received:
January 6,
2020
Footnotes
☆All authors meet criteria for authorship.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
