Percutaneous microwave ablation of larger hepatocellular carcinoma

AimTo evaluate the efficacy and safety of percutaneous microwave ablation (MWA) in patients with larger hepatocellular carcinoma (HCC) tumours.Materials and methodsEighty HCC patients with the maximum tumour measuring between 3 and 8 cm were treated using MWA. Of these patients, 57 had initial HCC, while 23 had recurrent HCC. Fifty-two patients had a main tumour measuring 3–5 cm, and 28 had a main tumour measuring 5–8 cm. Local tumour control, complications, long-term survival, and prognostic factors were analysed.ResultsComplete ablation after the initial treatment was achieved in 70 of 80 (87.5%) patients. Sixteen of the 72 (22.2%) successfully treated patients developed local recurrence. Major complications occurred in 7.5% patients. No procedure-related mortality was observed. The 1, 2, 3, and 5 year overall survival rates after the initial ablation were 81.1, 68.2, 56.5, and 34.6%, with a median survival of 56 months. Univariate analysis revealed that small tumour size (p = 0.003) and pre-ablation α-foetoprotein (AFP) level ≤400 ng/ml (p = 0.042) were favourable prognostic factors of overall survival. Multivariate analysis identified only tumour size as the independent prognosis factor (p = 0.008).ConclusionPercutaneous MWA is effective and safe for treating larger HCC tumours. The local tumour control and long-term survival are acceptable.