Zachary Makovich1, JerryRay Logemann1, Liwei Chen2, Rahul Mhaskar2, Junsung Choi3, Nainesh Parikh3, Ghassan El-Haddad3, Bela Kis4. 1. Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive Tampa, FL 33612, United States; University of South Florida Morsani College of Medicine, 546 Channelside Dr, Tampa, FL 33602, United States. 2. University of South Florida Morsani College of Medicine, 546 Channelside Dr, Tampa, FL 33602, United States. 3. Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive Tampa, FL 33612, United States. 4. Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive Tampa, FL 33612, United States. Electronic address: bela.kis@moffitt.org.
Abstract
AIM: To assess the safety and efficacy of CT-guided microwave ablation (MWA) of hepatocellular carcinoma (HCC) near large blood vessels and the diaphragm by analyzing procedural complications and local tumor progression (LTP). METHODS: From October 2013 through January 2019, 80 patients (54 males and 26 females) with 136 tumors who underwent CT-guided MWA of HCC were included in this retrospective analysis. MWA was performed on 43 perivascular HCC (≤5 mm from a vessel measuring ≥5 mm in diameter), 38 subdiaphragmatic HCC (≤5 mm from diaphragm), and 64 control HCC. Risk factors for local tumor progression (LTP), overall survival, and complications were analyzed using the Chi-square and Cox proportional hazards model methods. RESULTS: The technical success rate of MWA was 100%. Complication incidence was not significantly different between perivascular and control tumors (20.9% vs 10.9%; p = 0.155) or between subdiaphragmatic and control tumors (21.1% vs 10.9%; p = 0.163). The effect of lesion location on LTP disappeared while controlling for age and lesion size. There was no significant difference in median survival time between patients who had only control tumors (38.8 months) compared to patients with at least one perivascular or subdiaphragmatic tumor (42.5 months; p = 0.098). CONCLUSION: CT-guided percutaneous MWA of perivascular and subdiaphragmatic HCC tumors is safe and effective. The local tumor recurrence and survival was not significantly different compared to control tumors.
AIM: To assess the safety and efficacy of CT-guided microwave ablation (MWA) of hepatocellular carcinoma (HCC) near large blood vessels and the diaphragm by analyzing procedural complications and local tumor progression (LTP). METHODS: From October 2013 through January 2019, 80 patients (54 males and 26 females) with 136 tumors who underwent CT-guided MWA of HCC were included in this retrospective analysis. MWA was performed on 43 perivascular HCC (≤5 mm from a vessel measuring ≥5 mm in diameter), 38 subdiaphragmatic HCC (≤5 mm from diaphragm), and 64 control HCC. Risk factors for local tumor progression (LTP), overall survival, and complications were analyzed using the Chi-square and Cox proportional hazards model methods. RESULTS: The technical success rate of MWA was 100%. Complication incidence was not significantly different between perivascular and control tumors (20.9% vs 10.9%; p = 0.155) or between subdiaphragmatic and control tumors (21.1% vs 10.9%; p = 0.163). The effect of lesion location on LTP disappeared while controlling for age and lesion size. There was no significant difference in median survival time between patients who had only control tumors (38.8 months) compared to patients with at least one perivascular or subdiaphragmatic tumor (42.5 months; p = 0.098). CONCLUSION: CT-guided percutaneous MWA of perivascular and subdiaphragmatic HCC tumors is safe and effective. The local tumor recurrence and survival was not significantly different compared to control tumors.
Authors: Ijin Joo; Kenneth W Morrow; Steven S Raman; Justin P McWilliams; James W Sayre; David S Lu Journal: Eur Radiol Date: 2022-04-07 Impact factor: 7.034