4.5 Article

Operative Microwave Ablation for Hepatocellular Carcinoma Within 3 cm and 3 Nodules: Experience in 559 Patients

Journal

JOURNAL OF GASTROINTESTINAL SURGERY
Volume 26, Issue 3, Pages 615-622

Publisher

SPRINGER
DOI: 10.1007/s11605-021-05166-z

Keywords

Hepatocellular carcinoma; Local ablation; Microwave ablation; Radiofrequency ablation

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The study examined the long-term outcomes of operative microwave ablation for hepatocellular carcinoma within 3 cm and 3 nodules, revealing good overall survival rates and recurrence-free survival rates. Independent risk factors for prognosis were identified, and a prognostic staging model based on these factors was developed to predict outcomes.
Background There are few published data regarding long-term outcome survival after microwave ablation (MWA) for hepatocellular carcinoma (HCC) within 3 cm and 3 nodules. The aim of this study was to examine long-term outcomes after operative MWA for HCC within 3 cm and 3 nodules. Methods This cohort of this retrospective study comprised 559 patients who underwent operative MWA for HCC within 3 cm and 3 nodules in our institute between 1996 and 2017. We analyzed overall survival (OS) and recurrence-free survival (RFS), and evaluated factors related to prognosis. Results Median follow-up time was 69 months for the entire cohort. OS rates were 1-year: 98%, 3-year: 87%, 5-year: 73%, and 10-year:39%; RFS rates were 1-year: 91%, 3-year: 60%, 5-year: 42%, and 10-year: 21%. Multivariate analysis revealed that hepatitis C virus (HCV)-positive status, ALBI grade 2 or 3, maximum tumor diameter >= 20 mm, and multiple nodules were independent risk factors for both OS and RFS. A prognostic staging model using one point for each risk factor provided a well-categorized predictive model. The 5-year OS rates were 93%, 81%, and 57% for scores of 0, 1 or 2, and 3 or 4, respectively (P < 0.001). The 5-year RFS rates were 70%, 48%, and 28% for scores of 0, 1 or 2, and 3 or 4, respectively (P < 0.001). Conclusions Our results revealed good long-term outcomes after operative MWA for HCC within 3 cm and 3 nodules.

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