Percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: a long-term follow-up

To retrospectively evaluate the effectiveness and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) adjacent to large vessels.

From February 2006 to February 2013, 452 patients with 605 HCC nodules were treated with US-guided percutaneous MWA. Into large vessels group (Group L), 139 patients with 163 lesions (diameter, 1.0-7.0 cm; mean, 2.5±1.1 cm) located less than 5mm away from large vessels were enrolled. And 313 patients with 442 lesions (diameter, 1.0-8.0 cm; mean, 2.5±1.2 cm) located more than 5mm away from hepatic surface, large vessels, gallbladder and gastrointestinal tract were included in control group (Group C). During the ablation, the temperature of marginal ablation tissues was monitored and controlled.

The median follow-up time was 24.5 months (range 2.1-87.7 months) in Group L, and 25.7 months (range 1.6-93.9 months) in Group C. Technical effectiveness was achieved in 157 of 163 (96.3%) tumors in Group L and 429 of 442 (97.1%) tumors in Group C, respectively (p>0.05). The 1-, 3- and 5-year local tumor progression rates and the 1-, 3- and 5-year accumulative survival rates in the two groups have no significantly statistical differences. In addition, no immediate or periprocedural major complications, no delayed complication of vessels or bile ducts injury were found in both of the two groups.

With strict temperature monitoring, US-guided percutaneous MWA is an efficient and safe technology in treating hepatocellular carcinoma adjacent to large vessels.