Abstract
Objective
The aim of this study was to evaluate the clinical outcomes of ultrasound-guided percutaneous microwave ablation (US-guided PMWA) for the treatment of hepatocellular carcinoma (HCC) with the analysis of prognostic factors.
Materials and methods
The treatment and survival parameters of 433 patients with HCC (≤10 cm), who met the inclusion criteria and had received US-guided PMWA in Renji Hospital from July 2010 to November 2014, were retrospectively analyzed. Imaging examination (contrast-enhanced CT or MR) and tumor markers (AFP and CA199) 1 month after MWA were used to evaluate the efficacy of US-guided PMWA. SPSS software was used to perform all statistical analyses.
Results
The initial complete ablation (CA) rate was 94.9 % (411/433). Twenty-two patients with incomplete ablation received repeat PMWA, and the total CA rate was up to 98.6 % (427/433). Multiple tumor number, tumor >5 cm in diameter, and higher serum AFP level (>20 ng/ml) were significant unfavorable prognosticators of progression-free survival (PFS). The cumulative 1-, 2-, and 3-year overall survival (OS) rates were 83.5, 66.1, and 58.7 %, respectively (median: 43 months). Tumor >5 cm in diameter and serum AFP >400 ng/ml were significant unfavorable prognosticators of OS.
Conclusions
PMWA is well tolerated in HCC patients and capable of offering high CA rate. Tumor number, tumor size, and AFP level were significant prognosticators of patients’ PFS, whereas tumor size and AFP level were significant prognosticators of OS.
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Abbreviations
- HCC:
-
Hepatocellular carcinoma
- US-guided PMWA:
-
Ultrasound-guided percutaneous microwave ablation
- HBV:
-
Hepatitis B virus
- CA:
-
Complete ablation
- PFS:
-
Progression-free survival
- OS:
-
Overall survival
- RFA:
-
Radiofrequency ablation
- MWA:
-
Microwave ablation
- PEI:
-
Percutaneous ethanol injection
- TACE:
-
Transarterial chemoembolization
- LTP:
-
Local tumor progression
- IDR:
-
Intrahepatic distant recurrence
- EM:
-
Extrahepatic metastases
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Acknowledgments
SiCong Ma collected the data of the patients, designed the pipeline of the analysis, and drafted the manuscript. Min Ding designed the pipeline of the analysis, performed the statistical analysis, and drafted the manuscript. Jiang Li designed the pipeline of the analysis and drafted the manuscript. Bo Zhai conceived and coordinated the overall study and revised the manuscript. All authors read and approved the final manuscript.
Funding
This research was supported by a grant from The National Natural Science Fund (No. 81472845).
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Ma Sicong, Ding Min, and Li Jiang have contributed equally to this study.
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Ma, S., Ding, M., Li, J. et al. Ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma: clinical outcomes and prognostic factors. J Cancer Res Clin Oncol 143, 131–142 (2017). https://doi.org/10.1007/s00432-016-2266-5
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DOI: https://doi.org/10.1007/s00432-016-2266-5