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Comparison of radiofrequency and microwave ablation and identification of risk factors for primary treatment failure and local progression

      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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