Jian Kong1, Ruize Gao1, Shilun Wu1, Yaoping Shi2, Tao Yin3, Shigang Guo4, Zonghai Xin5, Aolei Li6, Xinliang Kong7, Demin Ma8, Bo Zhai9, Wenbing Sun10, Jun Gao11. 1. Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated To Capital Medical University, Beijing, 100043, China. 2. Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200120, China. 3. Department of General Surgery, Affiliated Hospital of Chifeng University, Chifeng, 024000, Inner Mongolia Autonomous Region, China. 4. Department of General Surgery, Chaoyang Central Hospital, Chaoyang, 122000, Liaoning Province, China. 5. Department of General Surgery, Binzhou Second People's Hospital, Binzhou, 256000, Shandong Province, China. 6. Department of General Surgery, Chaoyang Second Hospital, Chaoyang, 122000, Liaoning Province, China. 7. Department of Hepatobiliary Surgery, Rizhao Central Hospital, Rizhao, 276801, Shandong Province, China. 8. Department of Hepatobiliary Surgery, Dezhou People's Hospital, Dezhou, 253000, Shandong Province, China. 9. Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200120, China. zhaiboshi@sina.com. 10. Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated To Capital Medical University, Beijing, 100043, China. sunwenbing@bjcyh.com. 11. Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated To Capital Medical University, Beijing, 100043, China. gaojun8430@163.com.
Abstract
OBJECTIVES: To compare the safety and efficacy of microwave ablation (MWA) and radiofrequency ablation (RFA) for such hemangiomas (5-9.9 cm in diameter). METHODS: This multicenter retrospective cohort study investigated the differences in technical success, ablation time, complete ablation, complications, hospital stay, and clinical response between MWA and RFA. A total of 452 patients with hepatic hemangiomas were screened. Propensity score matching was performed. Univariable and multivariate regression analyses were used. RESULTS: Among the 452 patients, 394 met the eligibility criteria and completed the follow-up. After the propensity score matching analysis, 72 pairs of patients were created. No technical failures were found. The RFA group had a longer ablation time (48.63 ± 18.11 min versus [vs.] 37.18 ± 15.86 min, p < 0.001), higher morbidity of hemoglobinuria (77.78% vs. 50.00%, p < 0.001), and longer hospital stay (5.01 ± 1.56 days vs. 4.34 ± 1.42 days, p < 0.05) than the MWA group. The treatment methods (p = 0.032, OR = 0.105, 95% CI = 0.013-0.821), size of the hemangioma (p = 0.021, OR = 5.243, 95% CI = 1.285-21.391), and time of ablation (p = 0.031, OR = 1.145, 95% CI = 1.013-1.294) were significant independent risk factors associated with hemoglobinuria. No recurrence or delayed complications were observed. There were no differences in complete ablation, clinical response, and health-related quality of life between the groups. CONCLUSIONS: MWA and RFA appear to be effective treatments for large hepatic hemangiomas. However, MWA had a shorter ablation time than RFA, and MWA was associated with fewer hemolysis-related complications and shorter hospital stays. KEY POINTS: • MWA and RFA appear to be effective treatments for large hepatic hemangiomas. • MWA had a shorter ablation time than RFA. • MWA was associated with fewer hemolysis-related complications and shorter hospital stays.
OBJECTIVES: To compare the safety and efficacy of microwave ablation (MWA) and radiofrequency ablation (RFA) for such hemangiomas (5-9.9 cm in diameter). METHODS: This multicenter retrospective cohort study investigated the differences in technical success, ablation time, complete ablation, complications, hospital stay, and clinical response between MWA and RFA. A total of 452 patients with hepatic hemangiomas were screened. Propensity score matching was performed. Univariable and multivariate regression analyses were used. RESULTS: Among the 452 patients, 394 met the eligibility criteria and completed the follow-up. After the propensity score matching analysis, 72 pairs of patients were created. No technical failures were found. The RFA group had a longer ablation time (48.63 ± 18.11 min versus [vs.] 37.18 ± 15.86 min, p < 0.001), higher morbidity of hemoglobinuria (77.78% vs. 50.00%, p < 0.001), and longer hospital stay (5.01 ± 1.56 days vs. 4.34 ± 1.42 days, p < 0.05) than the MWA group. The treatment methods (p = 0.032, OR = 0.105, 95% CI = 0.013-0.821), size of the hemangioma (p = 0.021, OR = 5.243, 95% CI = 1.285-21.391), and time of ablation (p = 0.031, OR = 1.145, 95% CI = 1.013-1.294) were significant independent risk factors associated with hemoglobinuria. No recurrence or delayed complications were observed. There were no differences in complete ablation, clinical response, and health-related quality of life between the groups. CONCLUSIONS: MWA and RFA appear to be effective treatments for large hepatic hemangiomas. However, MWA had a shorter ablation time than RFA, and MWA was associated with fewer hemolysis-related complications and shorter hospital stays. KEY POINTS: • MWA and RFA appear to be effective treatments for large hepatic hemangiomas. • MWA had a shorter ablation time than RFA. • MWA was associated with fewer hemolysis-related complications and shorter hospital stays.
Authors: Soo Young Park; Won Young Tak; Min Kyu Jung; Seong Woo Jeon; Chang Min Cho; Young Oh Kweon; Kab Chul Kim Journal: J Hepatol Date: 2010-09-29 Impact factor: 25.083