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Microwave ablation versus surgical resection for subcapsular hepatocellular carcinoma: a propensity score–matched study of long-term therapeutic outcomes

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The therapeutic efficacy of microwave ablation (MWA) for subcapsular hepatocellular carcinoma (HCC) has not been well characterized. We aimed to compare the long-term outcomes of MWA and surgical resection (SR) in patients with subcapsular HCC.

Methods

This retrospective study comprised 321 patients with subcapsular HCC meeting the Milan criteria who received MWA (n = 99) or SR (n = 222). Local tumor progression (LTP), overall survival (OS), and disease-free survival (DFS) were analyzed using propensity score matching (PSM) to compare the therapeutic efficacy.

Results

In the total cohort, there were no significant differences in 5-year LTP rates (14.0% vs. 8.9%, p = 0.12), OS rates (70.7% vs. 73.2%, p = 0.63), and DFS rates (38.3% vs. 41.2%, p = 0.22) between the MWA and SR groups. After PSM, the cumulative LTP rates at 1, 3, and 5 years were 9.7%, 14.0%, and 16.4% in the MWA group (n = 84) and 7.2%, 8.6%, and 10.6% in the SR group (n = 84), respectively, with no significant difference (p = 0.31). Neither corresponding OS rates (96.4%, 84.8%, and 73.0% vs. 95.2%, 85.5%, and 72.1%, p = 0.89) nor DFS rates (76.0%, 52.6%, and 38.1% vs. 76.2%, 44.7%, and 32.3%, p = 0.43) were significantly different between the MWA and SR groups. Whereas MWA obtained fewer complications for both cohorts (both p < 0.05).

Conclusion

MWA showed comparable long-term therapeutic outcomes to SR, and it might be an alternative curative option for subcapsular HCC within the Milan criteria.

Key Points

• Microwave ablation showed comparable local tumor progression, overall survival, and disease-free survival to surgical resection for subcapsular hepatocellular carcinoma meeting the Milan criteria.

• Microwave ablation obtained fewer complications and shorter postoperative hospital stay.

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Abbreviations

ALBI:

Albumin-bilirubin

DFS:

Disease-free survival

HCC:

Hepatocellular carcinoma

LTP:

Local tumor progression

MWA:

Microwave ablation

OS:

Overall survival

PSM:

Propensity score matching

SR:

Surgical resection

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Funding

This work was supported in part by the Natural Science Foundation of Shandong Province (No. ZR2020MH285).

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Authors and Affiliations

  1. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324, Jing 5 Rd, Jinan, 250021, Shandong Province, China

    Kaiwen Liu, Xinzi Sui & Xinya Zhao

  2. Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China

    Hang Zheng

  3. Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong Province, China

    Bo Liu

  4. Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China

    Min Meng

  5. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China

    Yuemin Feng & Qiang Zhu

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  1. Kaiwen Liu
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Correspondence to Xinya Zhao.

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The scientific guarantor of this publication is Dr. Xinya Zhao.

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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.

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• multicenter study

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Liu, K., Zheng, H., Sui, X. et al. Microwave ablation versus surgical resection for subcapsular hepatocellular carcinoma: a propensity score–matched study of long-term therapeutic outcomes. Eur Radiol 33, 1938–1948 (2023). https://doi.org/10.1007/s00330-022-09135-1

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  • DOI: https://doi.org/10.1007/s00330-022-09135-1

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