Microwave versus Radiofrequency Ablation Treatment for Hepatocellular Carcinoma: A Comparison of Efficacy at a Single Center

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• 作者：Theodora A. Potretzke ; MD^a ; Timothy J. Ziemlewicz ; MD^a ; ^{tziemlewicz@uwhealth.org" class="auth_mail" title="E-mail the corresponding author} ; J. Louis Hinshaw ; MD^a ; Meghan G. Lubner ; MD^a ; Shane A. Wells ; MD^a ; Christopher L. Brace ; PhD^a ; ^b ; ^c ; Parul Agarwal ; MD^d ; Fred T. Lee Jr ; MD^a ; ^b
• 关键词：CI ; confidence interval ; HCC ; hepatocellular carcinoma ; HR ; hazard ratio ; LTP ; local tumor progression ; MW ; microwave
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：27
• 期：5
• 页码：631-638
• 全文大小：697 K

文摘

To compare efficacy and major complication rates of radiofrequency (RF) and microwave (MW) ablation for treatment of hepatocellular carcinoma (HCC).

Materials and Methods

This retrospective single-center study included 69 tumors in 55 patients treated by RF ablation and 136 tumors in 99 patients treated by MW ablation between 2001 and 2013. RF and MW ablation devices included straight 17-gauge applicators. Overall survival and rates of local tumor progression (LTP) were evaluated using Kaplan-Meier techniques with Cox proportional hazard ratio (HR) models and competing risk regression of LTP.

Results

RF and MW cohorts were similar in age (P = .22), Model for End-Stage Liver Disease score (P = .24), and tumor size (mean 2.4 cm [range, 0.6–4.5 cm] and 2.2 cm [0.5–4.2 cm], P = .09). Median length of follow-up was 31 months for RF and 24 months for MW. Rate of LTP was 17.7% with RF and 8.8% with MW. Corresponding HR from Cox and competing risk models was 2.17 (95% confidence interval [CI], 1.04–4.50; P = 0.04) and 2.01 (95% CI, 0.95–4.26; P = .07), respectively. There was improved survival for patients treated with MW ablation, although this was not statistically significant (Cox HR, 1.59 [95% CI, 0.91–2.77; P = .103]). There were few major (≥ grade C) complications (2 for RF, 1 for MW; P = .28).

Conclusions

Treating HCC percutaneously with RF or MW ablation was associated with high primary efficacy and durable response, with lower rates of LTP after MW ablation.