Journal
EUROPEAN RADIOLOGY
Volume 31, Issue 7, Pages 4764-4773Publisher
SPRINGER
DOI: 10.1007/s00330-020-07571-5
Keywords
Hepatocellular carcinoma; Liver neoplasms; Radiofrequency ablation; Microwave; Ablation techniques
Funding
- National Scientific Foundation Committee of China [81371652, 81627803, 81871374, 81971625, 91859201]
- National Scientific Foundation Committee of Beijing [JQ18021]
- Fostering Funds for National Distinguished Young Scholar Science Fund [NCRCG-PLAGH-2019011]
- National Clinical Research Center for Geriatric Diseases of Chinese PLA General Hospital [NCRCG-PLAGH-2019011]
- National Key R&D Program of Ministry of Science and Technology of China [2018ZX10723204]
- National Key R&D Program of China [2017YFC0112000]
- State Key Project on Infectious Disease of China [2018ZX10723204]
- 5010 Project of Clinical Research in Sun Yat-sen University [2016002]
- Science and Technology Program of Guangzhou, China [201704020134]
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In patients with small single perivascular hepatocellular carcinoma, microwave ablation exhibited better tumor control than radiofrequency ablation, with a significantly higher local tumor progression rate observed in the radiofrequency ablation group. Additionally, there was a significant interaction effect of ablation modality and type of peritumoral vessel on local tumor progression, with differences observed in periportal HCC but not perivenous HCC.
Objectives We aimed to compare the therapeutic outcomes of radiofrequency ablation (RFA) and microwave ablation (MWA) as first-line therapies in patients with small single perivascular hepatocellular carcinoma (HCC). Methods A total of 144 eligible patients with small (<= 3 cm) single perivascular (proximity to hepatic and portal veins) HCC who underwent RFA (N = 70) or MWA (N = 74) as first-line treatment were included. The overall survival (OS), disease-free survival (DFS), and local tumor progression (LTP) rates between the two ablation modalities were compared. The inverse probability of treatment weighting (IPTW) method was used to reduce selection bias. Subgroup analysis was performed according to the type of hepatic vessels. Results After a median follow-up time of 38.2 months, there were no significant differences in OS (5-year OS: RFA 77.7% vs. MWA 74.6%; p = 0.600) and DFS (5-year DFS: RFA 24.7% vs. MWA 40.4%; p = 0.570). However, a significantly higher LTP rate was observed in the RFA group than the MWA group (5-year LTP: RFA 24.3% vs. MWA 8.4%; p = 0.030). IPTW-adjusted analyses revealed similar results. The treatment modality (RFA vs. MWA: HR 7.861, 95% CI 1.642-37.635, p = 0.010) was an independent prognostic factor for LTP. We observed a significant interaction effect of ablation modality and type of peritumoral vessel on LTP (p = 0.034). For patients with periportal HCC, the LTP rate was significantly higher in the RFA group than in the MWA group (p = 0.045). However, this difference was not observed in patients with perivenous HCC (p = 0.116). Conclusions In patients with a small single periportal HCC, MWA exhibited better tumor control than RFA.
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