Related Experiment Video
Updated: Jun 13, 2025
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Laparoscopic and Percutaneous Microwave Ablation for Hepatocellular Carcinoma-An Institutional Analysis of
Bartholomew McKay1,2, Edward Meehan3, Lynn Chong1,4
1Department of Upper GI & HPB Surgery, St. Vincent's Hospital, Fitzroy, Australia.
Introduction:
Microwave ablation (MWA) is a locoregional thermoablative treatment for early HCC with equivalent outcomes to liver resection with reduced morbidity. Our study aimed to assess the oncological and perioperative outcomes of percutaneous and surgical MWA demonstrating their complementary utilization.
Methods:
All patients undergoing percutaneous (pMWA) and surgical (sMWA) MWA for HCC at St Vincent's Hospital in Melbourne, Australia between August 2011 and April 2023 were included.
Results:
140 microwave ablations occurred in 107 patients with a median follow-up of 37.1 months (range 2.4-105.9 months). There were 51 pMWA and 56 sMWA cases, of which 53 were undertaken laparoscopically. Surgical ablations had a higher BCLC stage, and due to more instances of multiplicity, sMWA delivered more ablations and energy per lesion. This was associated with longer procedural time (69.5 min vs. 45 min and p < 0.001) and postoperative length of stay (1 day vs. 2 days and p < 0.001). Clavien-Dindo III or more complications were no different between the groups (p = 0.404). Local recurrence was significantly higher in the percutaneous group (31.4% vs. 10.7% and p = 0.016), and multivariate analysis demonstrated that technique was a predictor of local recurrence (sMWA HR 0.22, 95% CI 0.08-0.65, and p = 0.006). The median disease-free survival was 3.0 years (95% CI 2.6-NS) for sMWA and 1.7 years (95% CI 1.5-3.7) for pMWA, but the difference was not significant (p = 0.36). There were insufficient events to calculate median overall survival for each group; however, no differences were observed with an overall 5-year survival estimate of 0.64 (95% CI 0.54-0.77 and p = 0.86).
Conclusion:
pMWA and sMWA are effective locoregional therapies for HCC. sMWA has the ability to deliver more energy per ablation with reduced local recurrence. However, overall survival is unaffected using the approach and both modalities should be used in a complimentary manner.
