Skip to main content
Log in

Safety and Efficacy of Microwave Ablation of Hepatic Tumors: A Prospective Review of a 5-Year Experience

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study was designed to evaluate the safety, efficiency, effectiveness, and overall long-term outcome in patients treated with microwave thermal ablation of hepatic tumors. Microwave ablation technology represents the next generation in ablative techniques for the treatment of hepatic malignancies. Currently there have been no large reports of its use in the United States with appropriate long-term follow-up.

Methods

An institutional review board-approved prospective phase II study of microwave ablation of hepatic malignancies from January 2004 to January 2009 was performed. All complications were recorded up to 90 days from operation and reported using an established five-point grading scale.

Results

One hundred patients underwent 270 ablations for hepatic malignancies. The most tumor types were as follows: metastatic colorectal cancer (50%), hepatocellular carcinoma (17%), metastatic carcinoid (11%), and other metastatic disease (22%). A majority of patents (53%) underwent combination hepatic resection and microwave ablation; 38% underwent ablation alone, 9% underwent ablation and additional organ resection, with 68% open procedures. Median tumor size was 3.0 (range, 0.6–6.0) cm, median number of tumors was 2 (range, 1–18), and median total ablation time was 13 (range, 5–45) min. Overall 90-day mortality was 0% and morbidity was 29%. One patient developed a hepatic abscess and no patients experienced bleeding complications. After a median follow-up of 36 months, 5 patients (5%) had incomplete ablation, 2 (2%) had local recurrence at the ablated site, and 37 (37%) developed intrahepatic recurrence at nonablated sites.

Conclusions

Microwave ablation of hepatic tumors is a safe and effective method for treating unresectable hepatic tumors, with a low rate of local recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Seki S, Sakaguchi H, Kadoya H, et al. Laparoscopic microwave coagulation therapy for hepatocellular carcinoma. Endoscopy. 2000;32:591–7.

    Article  CAS  PubMed  Google Scholar 

  2. Ohmoto K, Miyake I, Tsuduki M, et al. Percutaneous microwave coagulation therapy for unresectable hepatocellular carcinoma. Hepatogastroenterology. 1999;46:2894–900.

    CAS  PubMed  Google Scholar 

  3. Shibata T, Iimuro Y, Yamamoto Y, et al. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology. 2002;223:331–7.

    Article  PubMed  Google Scholar 

  4. Sato M, Watanabe Y, Ueda S, et al. Microwave coagulation therapy for hepatocellular carcinoma. Gastroenterology. 1996;110:1507–14.

    Article  CAS  PubMed  Google Scholar 

  5. Lu MD, Chen JW, Xie XY, et al. Hepatocellular carcinoma: US-guided percutaneous microwave coagulation therapy. Radiology. 2001;221:167–72.

    Article  CAS  PubMed  Google Scholar 

  6. Skinner MG, Iizuka MN, Kolios MC, et al. A theoretical comparison of energy sources–microwave, ultrasound and laser–for interstitial thermal therapy. Phys Med Biol. 1998;43:3535–47.

    Article  CAS  PubMed  Google Scholar 

  7. Wright AS, Sampson LA, Warner TF, et al. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology. 2005;236:132–9.

    Article  PubMed  Google Scholar 

  8. Wright AS, Lee FT Jr, Mahvi DM. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol. 2003;10:275–83.

    Article  PubMed  Google Scholar 

  9. Martin RC, Scoggins CR, McMasters KM. Microwave hepatic ablation: initial experience of safety and efficacy. J Surg Oncol. 2007;96:481–6.

    Article  PubMed  Google Scholar 

  10. Couinaud C. Le foie: Etudes anatomiques et Chirurgicales. Paris: Masson & Cie; 1957.

    Google Scholar 

  11. Vauthey JN, Choti MA, Helton WS. AHPBA/SSO/SSAT Consensus Conference on hepatic colorectal metastases: rationale and overview of the conference. January 25, 2006. Ann Surg Oncol. 2006;13:1259–60.

    Article  PubMed  Google Scholar 

  12. Martin RC, Jarnagin WR, Fong Y, et al. The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion? J Am Coll Surg. 2003;196:402–9.

    Article  PubMed  Google Scholar 

  13. Martin RC, Edwards MJ, McMasters KM. Morbidity of adjuvant hepatic arterial infusion pump chemotherapy in the management of colorectal cancer metastatic to the liver. Am J Surg. 2004;188:714–21.

    Article  PubMed  Google Scholar 

  14. Reuter NP, Woodall CE, Scoggins CR, et al. Radiofrequency ablation vs. resection for hepatic colorectal metastasis: therapeutically equivalent? J Gastrointest Surg. 2008.

  15. Lu MD, Xu HX, Xie XY, et al. Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol. 2005;40:1054–60.

    Article  PubMed  Google Scholar 

  16. Siperstein A, Garland A, Engle K, et al. Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors. Ann Surg Oncol. 2000;7:106–13.

    Article  CAS  PubMed  Google Scholar 

  17. Goldberg SN, Charboneau JW, Dodd GD III, et al. Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology. 2003;228:335–45.

    Article  PubMed  Google Scholar 

  18. Diederich CJ. Thermal ablation and high-temperature thermal therapy: overview of technology and clinical implementation. Int J Hyperthermia. 2005;21:745–53.

    Article  PubMed  Google Scholar 

  19. Iannitti DA, Martin RC, Simon CJ, et al. Hepatic tumor ablation with clustered microwave antennae: the U.S. Phase II Trial. HPB (Oxford). 2007;9:120–4.

    Google Scholar 

  20. Organ LW. Electrophysiologic principles of radiofrequency lesion making. Appl Neurophysiol. 1976;39:69–76.

    PubMed  Google Scholar 

  21. Goldberg SN, Gazelle GS, Solbiati L, et al. Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode. Acad Radiol. 1996;3:636–44.

    Article  CAS  PubMed  Google Scholar 

  22. Abe T, Shinzawa H, Wakabayashi H, et al. Value of laparoscopic microwave coagulation therapy for hepatocellular carcinoma in relation to tumor size and location. Endoscopy. 2000;32:598–603.

    Article  CAS  PubMed  Google Scholar 

  23. Aramaki M, Kawano K, Ohno T, et al. Microwave coagulation therapy for unresectable hepatocellular carcinoma. Hepatogastroenterology. 2004;51:1784–7.

    PubMed  Google Scholar 

  24. Liang P, Wang Y. Microwave ablation of hepatocellular carcinoma. Oncology. 2007;72(Suppl 1):124–31.

    Article  PubMed  Google Scholar 

  25. Kuang M, Lu MD, Xie XY, et al. Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna–experimental and clinical studies. Radiology. 2007;242:914–24.

    Article  PubMed  Google Scholar 

  26. Yamanaka N, Tanaka T, Oriyama T, et al. Microwave coagulonecrotic therapy for hepatocellular carcinoma. World J Surg. 1996;20:1076–81.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert C. G. Martin MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martin, R.C.G., Scoggins, C.R. & McMasters, K.M. Safety and Efficacy of Microwave Ablation of Hepatic Tumors: A Prospective Review of a 5-Year Experience. Ann Surg Oncol 17, 171–178 (2010). https://doi.org/10.1245/s10434-009-0686-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-009-0686-z

Keywords

Navigation