Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma

Table 1 Baseline characteristics of patient and tumor between the two groups

Variables	FNP group, n = 70	CP group, n = 54	P value
Age (yr)1	58.6 ± 1.7	59.4 ± 1.4	0.728
Sex (M/F)	60/10	48/6	0.601
ECOG PS			0.200
0	22	23
1	48	31
AFP (ng/mL)			0.530
< 400	61	49
≥ 400	9	5
No. of nodules in each patient			0.871
1	47	37
2-3	23	17
Total no. of nodules	93	73
Tumor size before MWA (cm)			0.922
< 3	50	39
3-5	20	15
Mean tumor diameter (cm) pre-MWA	2.3 ± 0.1	2.2 ± 0.2	0.711
Proportion of TACE prior to MWA	50 (71.4%)	41 (75.9%)	0.574
Post-MWA hospital stay (d)1	3.3 ± 0.3	3.9 ± 0.2	0.130
Tumor location
HRL	49	34	0.409
Liver subcapsular region	30	16
Diaphragmatic surface	7	4
Adjacent to large vessel	8	7
Adjacent to gallbladder	3	4
Adjacent to gastrointestinal tract	1	3
LRL	21	20
LTP	11 (15.7%)	16 (29.6%)	0.063

¹Values are mean ± SE. P < 0.05 is significant; P > 0.05 is non-significant.

FNP: Fine needle-assisted puncture; CP: Conventional puncture; ECOG PS: Eastern Cooperative Oncology Group performance status rating; AFP: Alpha-fetoprotein; HRL: High-risk location; LRL: Low-risk location; LTP: Local tumor progression; MWA: Microwave ablation; TACE: Transarterial chemoembolization.

Table 2 Factors associated with local tumor progression

Factors	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex	0.706 (0.166, 2.966)	0.637
Age (yr): > 60; 60	1.041 (0.486, 2.229)	0.918
ECOG PS: 0; 1	3.169 (1.197, 8.392)	0.020	2.979 (1.108, 8.014)	0.031
Tumor number: 1; 2-3	3.370 (1.561, 7.277)	0.002	3.008 (1.383, 6.546)	0.005
AFP (ng/mL): < 400; ≥ 400	0.601 (0.142, 2.538)	0.488
Tumor size (cm): < 3; 3-5	1.649 (0.754, 3.603)	0.210
Auxiliary TACE pre-MWA: Yes; No	1.232 (0.497, 3.055)	0.653
Tumor location: HRL; LRL	1.523 (0.937, 2.476)	0.090
Puncture method: FNP technique; CP technique	2.205 (1.021, 4.761)	0.044	2.596 (1.197, 5.631)	0.016

AFP: Alpha-fetoprotein; CP: Conventional puncture; ECOG PS: Eastern Cooperative Oncology Group performance status rating; FNP: Fine needle-assisted puncture positioning; HRL: High-risk location; LRL: Low-risk location; MWA: Microwave ablation; TACE: Transarterial chemoembolization.

Table 3 Factors associated with recurrence-free survival

Factors	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex	0.547 (0.170, 1.764)	0.313
Age (yr): > 60; 60	1.021 (0.590, 1.767)	0.942
ECOG PS: 0; 1	1.831 (1.008, 3.325)	0.047	1.609 (0.878, 2.948)	0.124
Tumor number: 1; 2-3	3.692 (2.112, 6.456)	< 0.001	3.910 (2.195, 6.966)	< 0.001
AFP (ng/mL): < 400; ≥ 400	0.606 (0.218, 1.682)	0.336
Tumor size (cm): < 3; 3-5	1.491 (0.841, 2.642)	0.171
Auxiliary TACE pre-MWA: Yes; No	0.947 (0.504, 1.780)	0.867
Tumor location: HRL; LRL	1.060 (0.789, 1.424)	0.699
Puncture method: FNP technique; CP technique	2.078 (1.196, 3.612)	0.009	2.484 (1.415, 4.359)	0.002

AFP: Alpha-fetoprotein; CP: Conventional puncture; ECOG PS: Eastern Cooperative Oncology Group performance status rating; FNP: Fine needle-assisted puncture positioning; HRL: High-risk location; LRL: Low-risk location; MWA: Microwave ablation; TACE: Transarterial chemoembolization.

Table 4 Complications of computed tomography-guided microwave ablation

Type of reactions	FNP group, n = 70	CP group, n = 54	χ2	P value
Major complications			0.561	0.454
Bacteremia	1	0
Pneumothorax	1	4
Total	2	4
Minor complications			12.345	< 0.001
Postoperative pain	15	11
Postoperative fever	2	7
Self-limiting pneumothorax	2	1
Self-limiting pleural effusion	3	0
Transient elevation of aminotransferase	18	27
Bleeding at the probe-inserting point	1	2
Total	41	48

CP: Conventional puncture; FNP: Fine needle-assisted puncture positioning.