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DOI: 10.1055/s-0041-1723102
Hypervascular Nodules and Stiffer Liver are Associated with Recurrence after Microwave Ablation in Patients with Hepatocellular Carcinoma: A Double-Center Analysis
Authors
Funding Nil.
Abstract
Background and Aims The aim of this study was to detect the most important risk factors for recurrence after microwave ablation (MWA) of hepatocellular carcinoma (HCC).
Methods A total of 92 patients with 110 HCC focal lesions (FLs) underwent MWA therapy. All the patients underwent triphasic CT before and after 1 and 3 months of MWA therapy. Complete ablation and recurrence rates were recorded, and the risk factors associated with recurrence were analyzed.
Results Regarding the 110 HCC FLs that were detected pre-MWA, adequate ablation was recorded post-MWA procedure in 88 FLs (80%) and incomplete ablation in 22 FLs (showed residual contrast enhancement). However, there were newly detected lesions (17 FLs). The rate of recurrence was significantly higher in patients with multiple larger (> 4 cm) sized and hypervascular nodules. Diabetics were significantly associated with a higher recurrence rate of HCC. The rate of recurrence was significantly higher in patients with baseline level of serum alfa-fetoprotein (AFP) ≥200 ng/mL. Stiffer liver> 25 kPa had higher incidence for recurrence after ablation.
Conclusion Meticulous follow-up is mandatory in diabetic patients, patients with AFP > 200 ng/dL starting value, hypervascular large hepatic FL, and in stiffer liver> 25 kPa, as these patients have higher incidence for recurrence after ablation.
Publication History
Article published online:
19 March 2021
© 2020. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Ziada DH, El Sadany S, Soliman H. et al. Prevalence of hepatocellular carcinoma in chronic hepatitis C patients in Mid Delta, Egypt: a single center study. J Egypt Natl Canc Inst 2016; 28 (04) 257-262
- 2 Sheta E, El-Kalla F, El-Gharib M. et al. Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study. Eur J Gastroenterol Hepatol 2016; 28 (10) 1198-1203
- 3 Lu MD, Xu HX, Xie XY. et al. Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol 2005; 40 (11) 1054-1060
- 4 Xu Y, Shen Q, Wang N. et al. Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma. Chin J Cancer 2017; 36 (01) 14
- 5 Wang Y, Sun Y, Feng L, Gao Y, Ni X, Liang P. Internally cooled antenna for microwave ablation: results in ex vivo and in vivo porcine livers. Eur J Radiol 2008; 67 (02) 357-361
- 6 Hashimoto K, Ikeda Y, Korenaga D. et al. The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma. Cancer 2005; 103 (09) 1856-1864
- 7 Portolani N, Coniglio A, Ghidoni S. et al. Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg 2006; 243 (02) 229-235
- 8 Livraghi T, Meloni F, Di Stasi M. et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?. Hepatology 2008; 47 (01) 82-89
- 9 Bruix J, Sherman M. AASLD practice guidelines management of hepatocellular carcinoma: an update. JHepatol 2011;
- 10 Awad MM, Devgan L, Kamel IR, Torbensen M, Choti MA. Microwave ablation in a hepatic porcine model: correlation of CT and histopathologic findings. HPB (Oxford) 2007; 9 (05) 357-362
- 11 Moneir S, Abdel Moghny M, Ghazy M. et al. Transarterial chemoembolization (TACE) versus combined TACE and radiofrequency thermal ablation (RFA) in the treatment of unresectable non-early hepatocellular carcinoma in Egyptian patients. J Am Sci 2011; 7: 506-511
- 12 Medhat E, Abdel Aziz A, Nabeel M. et al. Value of microwave ablation in treatment of large lesions of hepatocellular carcinoma. J Dig Dis 2015; 16 (08) 456-463
- 13 Toshimori J, Nouso K, Nakamura S. et al. Local recurrence and complications after percutaneous radiofrequency ablation of hepatocellular carcinoma: a retrospective cohort study focused on tumor location. Acta Med Okayama 2015; 69 (04) 219-226
- 14 Lee SH, Kim SU, Jang JW. et al. Use of transient elastography to predict de novo recurrence after radiofrequency ablation for hepatocellular carcinoma. OncoTargets Ther 2015; 8: 347-356
- 15 Jung KS, Kim JH, Kim SU. et al. Liver stiffness value-based risk estimation of late recurrence after curative resection of hepatocellular carcinoma: development and validation of a predictive model. PLoS One 2014; 9 (06) e99167