Microwave ablation – a 7-years review

Purpose: We evaluated the effects of microwave ablation to malignancies.

Materials and methods: A 7-years review of conducted microwave ablation at Department of Gastroenterology, Waldklinikum Gera, Germany. We evaluated microwave ablation in terms of success rate and complications. The results after microwave ablation (local recurrence or devitalized necrosis) were checked with contrast-enhanced ultrasound (CEUS) in specified intervals.

Results: 59 microwave ablations of liver malignancies in 45 patients with curative intention were enrolled (5-times ablation in 2 patients, 3-times ablation in 1 patient, 2-times ablation in 3 patients because of local recurrences of the liver malignancies; 2-times ablation in 2 patients because of several liver malignancies). The histological examination of the previously conducted percutaneous liver biopsy showed 9 different entities (20 x HCC, 19 x CRC, 7 x breast cancer, 6 x cholangiocellular carcinoma, 3 x gastric carcinoma, once each RCC, ovarian cancer, ductal adenocarcinoma, urothelial carcinoma). One microwave ablation was accomplished at the kidney. The primary success rate (devitalized necrosis in CEUS) was 63%. The definitive success rate after several ablations was 80%. Major complications occured in 5% (one skin necrosis, 2 hepatic abscesses) and the rate of minor complications was 7% (2 bleedings, one liver hematoma, one abdominell wall hematoma).

Conclusion: Microwace ablation with the intention of a curative treatment is a effective and save alternative for patients with malignancies of various entities up to a size of 5 cm, especially when there is an increased risk in surgical resection. The success rate is high with a low rate of complications. The follow-up examination with CEUS is safe and radiation-free and does not interfere with renal or thyroid function.