Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 2997-3004
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.2997
Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation
Ai-Xue Sun, Zhi-Li Cheng, Pan-Pan Wu, Yue-Hong Sheng, Xiu-Juan Qu, Wen Lu, Cheng-Gong Zhao, Guo-Jun Qian
Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105th Hospital of Chinese PLA, Hefei 230031, Anhui Province, China
Ai-Xue Sun, Graduate School of Soochow University, Suzhou 215006, Jiangsu Province, China
Pan-Pan Wu, Yue-Hong Sheng, Xiu-Juan Qu, Wen Lu, Guo-Jun Qian, Department of Minimally Invasive Therapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA, Shanghai 200438, China
Author contributions: Sun AX, Qian GJ and Zhao CG contributed equally to this work; Sun AX, Cheng ZL, Wu PP, Sheng YH, Qu XJ, Lu W, Zhao CG and Qian GJ designed research; Sun AX, Wu PP, Lu W and Qian GJ performed research; Sun AX provided analytic tools; Sun AX and Wu PP analyzed data; and Sun AX, Cheng ZL and Zhao CG wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guo-Jun Qian, MD, Department of Minimally Invasive Therapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA, 225 Chang Hai Road, Shanghai 200438, China. qgjs@sina.com
Telephone: ++86-21-81875161 Fax: +86-21-81875161
Received: August 4, 2014
Peer-review started: August 21, 2014
First decision: September 15, 2014
Revised: October 13, 2014
Accepted: December 19, 2014
Article in press: December 22, 2014
Published online: March 14, 2015
Processing time: 223 Days and 20.8 Hours
Abstract

AIM: To evaluate the outcomes of patients with medium-sized hepatocellular carcinoma (HCC) who underwent percutaneous microwave ablation (MWA).

METHODS: We retrospectively reviewed all patients with a single medium-sized HCC who underwent percutaneous MWA from January 2010 to January 2013. Technical success, technical effectiveness and complications were subsequently observed. Survival curves were constructed using the Kaplan-Meier method. The Cox proportional hazards model was fitted to each variable. The relative prognostic significance of the variables for predicting overall survival rate, recurrence-free survival rate and local tumor recurrence(s) was assessed using univariate analysis. All variables with a P value < 0.20 were subjected to multivariate analysis.

RESULTS: The study included 182 patients (mean age, 58 years; age range: 22-86 years) with a single HCC (mean size, 3.72 ± 0.54 cm; range: 3.02-5.00 cm). The estimated technical effectiveness rate was 93% in 182 patients. The major complication rate was 2.7% (5/182), including liver abscess in 4 cases, and abdominal bleeding at the puncture site in 1 case. Thirty-day mortality rate was 0.5% (1/182). One patient died due to liver abscess-related septicemia. Cumulative recurrence-free survival and overall survival (OS) rates were 51%, 36%, 27% and 89%, 74%, 60% at 1, 2, and 3 years, respectively. Age (P = 0.017) and tumor diameter (P = 0.029) were independent factors associated with local tumor recurrence. None of the factors had a statistically significant impact on recurrence-free survival. Serum albumin level (P = 0.009) and new lesion(s) (P = 0.029) were independently associated with OS.

CONCLUSION: Percutaneous MWA is a relatively safe and effective treatment for patients with medium-sized HCC.

Keywords: Hepatocellular carcinoma; Medium-sized tumor; Microwave ablation; Outcomes; Cox analysis

Core tip: This is the first study on the clinical outcome of a large population with medium-sized hepatocellular carcinoma (HCC) treated with microwave ablation (MWA). Our results confirmed that percutaneous MWA is a relatively safe and effective treatment for patients with a single medium-sized HCC.