European Radiology

, Volume 27, Issue 9, pp 3877–3887 | Cite as

Microwave ablation for the treatment of hepatocellular carcinoma that met up-to-seven criteria: feasibility, local efficacy and long-term outcomes

  • Yun Xu
  • Qiang Shen
  • Pei Liu
  • Zhongqi Xu
  • Panpan Wu
  • Zhenghua Lu
  • Yi Chen
  • Bin Huang
  • Guojun QianEmail author



This study aimed to evaluate the feasibility, local efficacy and long-term outcomes of microwave (MW) ablation for the treatment of hepatocellular carcinoma (HCC) that met up-to-seven criteria.


Between January 2007 and January 2012, 142 HCC patients with 294 nodules, which conformed to up-to-seven criteria, were enrolled into this retrospective study. All patients were followed up for more than 3 years after receiving MW ablation. Technical success, complications, local tumour progression (LTP) and distant recurrence (DR) were monitored. Recurrence-free survival (RFS), overall survival (OS) and prognostic factors were analysed.


Primary technical efficacy was achieved in 95.2% (280/294) of the carcinomatous nodules, and major complications occurred in four (2.8%) patients. Among the 294 tumours, LTP was observed in 44 (15.0%) tumours. Among the 142 patients, DR was observed in 97 (68.3%) patients. The estimated OS rates after MW ablation at 1, 3 and 5 years were 97.2%, 75.4% and 50.6%, respectively; and the corresponding RFS rates were 76.1%, 33.1% and 19.5%, respectively.


MW ablation is a safe and effective treatment with a high rate of primary technical efficacy for patients with HCC that met up-to-seven criteria.

Key Points

The first study expanding MW ablation to HCC category beyond Milan criteria.

The first report that used up-to-seven criteria as indications for MW ablation.

HCC of up-to-seven criteria viewed as a subgroup of BCLC stage B.

MW ablation is safe and effective for treating HCC within up-to-seven criteria.

MW ablation is preferable in treating unresectable HCC within up-to-seven criteria.


Hepatocellular carcinoma Microwave ablation Up-to-seven criteria Therapeutic efficacy Prognostic factors 


Compliance with ethical standards


The scientific guarantor of this publication is Guojun Qian.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.


The authors state that this work has not received any funding.

Statistics and biometry

One of the authors: Yun Xu has significant statistical expertise.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Study subjects or cohorts overlap

No study subjects or cohorts have been previously reported.


  • retrospective

  • prognostic study

  • performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Yun Xu
    • 1
  • Qiang Shen
    • 1
  • Pei Liu
    • 1
  • Zhongqi Xu
    • 1
  • Panpan Wu
    • 1
  • Zhenghua Lu
    • 1
  • Yi Chen
    • 1
  • Bin Huang
    • 2
  • Guojun Qian
    • 1
    Email author
  1. 1.Department of minimal invasion therapy, Eastern Hepatobiliary Surgery HospitalSecond Military Medical University of Chinese PLAShanghaiChina
  2. 2.Department of radiology, Eastern Hepatobiliary Surgery HospitalSecond Military Medical University of Chinese PLAShanghaiChina

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