Wenwu Liu1,2, Yun Zheng1,2, Wei He1,2, Ruhai Zou1,3, Jiliang Qiu1,2, Jingxian Shen1,4, Zhiwen Yang1,2, Yuanping Zhang1,2, Chenwei Wang1,2, Yongjin Wang1,2, Dinglan Zuo1,2, Binkui Li1,2, Yunfei Yuan1,2. 1. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Centre, Guangzhou, China. 2. Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, China. 3. Department of Ultrasound, Sun Yat-Sen University Cancer Centre, Guangzhou, China. 4. Department of Medical Imaging, Sun Yat-Sen University Cancer Centre, Guangzhou, China.
Abstract
BACKGROUND: Whether microwave ablation (MWA) challenges the standard role of radiofrequency ablation (RFA) in treating early-stage hepatocellular carcinoma (HCC) remains unclear. AIM: To compare the efficacy of MWA vs RFA for treating primary HCC within the Milan criteria. METHODS: From January 2002 to January 2017, the oncological outcomes after MWA (126 patients) and RFA (436 patients) were analysed by propensity score matching. RESULTS: Before propensity score matching, for overall patients, MWA resulted in similar 5-year overall survival to RFA (80.1% vs 75.8%, P = 0.190) but better 5-year recurrence-free survival (28.1% vs 19.6%, P = 0.036). For solitary HCC ≤ 3 cm, MWA resulted in comparable 5-year overall survival (81.8% vs 77.1%, P = 0.170) to RFA but better 5-year recurrence-free survival (34.6% vs 24.0%, P = 0.042). After propensity score matching, MWA resulted in better 5-year overall survival (79.3% vs 68.4%, P = 0.021) and 5-year recurrence-free survival (27.9% vs 6.4%, P < 0.001) than RFA for HCC. For solitary HCC ≤3 cm, MWA resulted in comparable 5-year overall survival (81.2% vs 66.3%, P = 0.062) and 5-year recurrence-free survival (37.7% vs 17.4%, P = 0.088) to RFA. In Cox analysis, RFA modality, tumours located in risk areas and low serum albumin levels were unfavourable prognostic factors for overall survival. RFA modality, multiple tumours, tumour size and low serum albumin levels were unfavourable prognostic factors for recurrence-free survival (all P < 0.05). CONCLUSIONS: RFA is inferior to MWA for treating HCC within the Milan criteria, but has comparable efficacy to MWA for solitary HCC ≤ 3 cm.
BACKGROUND: Whether microwave ablation (MWA) challenges the standard role of radiofrequency ablation (RFA) in treating early-stage hepatocellular carcinoma (HCC) remains unclear. AIM: To compare the efficacy of MWA vs RFA for treating primary HCC within the Milan criteria. METHODS: From January 2002 to January 2017, the oncological outcomes after MWA (126 patients) and RFA (436 patients) were analysed by propensity score matching. RESULTS: Before propensity score matching, for overall patients, MWA resulted in similar 5-year overall survival to RFA (80.1% vs 75.8%, P = 0.190) but better 5-year recurrence-free survival (28.1% vs 19.6%, P = 0.036). For solitary HCC ≤ 3 cm, MWA resulted in comparable 5-year overall survival (81.8% vs 77.1%, P = 0.170) to RFA but better 5-year recurrence-free survival (34.6% vs 24.0%, P = 0.042). After propensity score matching, MWA resulted in better 5-year overall survival (79.3% vs 68.4%, P = 0.021) and 5-year recurrence-free survival (27.9% vs 6.4%, P < 0.001) than RFA for HCC. For solitary HCC ≤3 cm, MWA resulted in comparable 5-year overall survival (81.2% vs 66.3%, P = 0.062) and 5-year recurrence-free survival (37.7% vs 17.4%, P = 0.088) to RFA. In Cox analysis, RFA modality, tumours located in risk areas and low serum albumin levels were unfavourable prognostic factors for overall survival. RFA modality, multiple tumours, tumour size and low serum albumin levels were unfavourable prognostic factors for recurrence-free survival (all P < 0.05). CONCLUSIONS: RFA is inferior to MWA for treating HCC within the Milan criteria, but has comparable efficacy to MWA for solitary HCC ≤ 3 cm.
Authors: Chang Gon Kim; Hyun Woong Lee; Hye Jin Choi; Jung Il Lee; Hye Won Lee; Seung Up Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kwang-Hyub Han; Han Sang Kim; Kyung Hwan Kim; Seong Jin Choi; Yongun Kim; Kwan Sik Lee; Gyoung Min Kim; Man Deuk Kim; Jong Yoon Won; Do Yun Lee; Beom Kyung Kim Journal: Cancer Med Date: 2019-07-10 Impact factor: 4.452