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Abstract：
Contrasting data are available in the literature regarding the superiority of percutaneous microwave ablation (MWA) or radiofrequency ablation (RFA) in very early or early (BCLA 0 or A) hepatocellular carcinoma (HCC).
The primary outcome was to compare the efficacy of RFA and MWA in achieving complete response in cirrhotic patients with early and very early HCC. The secondary outcomes were to evaluate the overall survival and the recurrence rate.
A retrospective, observational, single-center study was performed. Inclusion criteria were liver cirrhosis, new diagnosis of a single node of HCC measuring a maximum of 50 mm or up to three nodules with diameter up to 35 mm, treatment with RFA or MWA. Radiological response was evaluated with multiphasic contrast-enhanced Computed Tomography or Magnetic Resonance Imaging at 5-7 weeks after thermal ablation. Complete response was defined when no vital tissue was detected after treatment.
Overall, 251 HCC patients were included in this study; 81 patients were treated with MWA and 170 with RFA. The complete response rate was similar in MWA and RFA groups (out of 331 nodules, 87.5% (91/104) were treated with MWA and 84.2% (186/221) were treated with RFA, p = 0.504). Interestingly, a subanalysis demonstrated that for 21-35 mm nodules, the probability to achieve a complete response using MWA was almost 5 times higher than for RFA (OR = 4.88, 95% CI 1.37-17.31, p = 0.014). Moreover, recurrence rate in 21-35 mm nodules was higher with RFA with respect to MWA (31.9% versus 13.5%, p = 0.019). Overall survival was 80.4% (45/56) when treated with MWA and 62.2% (56/90) when treated with RFA (p = 0.027). No significant difference was observed between MWA and RFA treatment in the 15-20 mm nodules group.
This study showed that MWA is more efficient than RFA in achieving complete response in HCC nodules with 21 to 35 mm diameter.
The primary outcome was to compare the efficacy of RFA and MWA in achieving complete response in cirrhotic patients with early and very early HCC. The secondary outcomes were to evaluate the overall survival and the recurrence rate.
A retrospective, observational, single-center study was performed. Inclusion criteria were liver cirrhosis, new diagnosis of a single node of HCC measuring a maximum of 50 mm or up to three nodules with diameter up to 35 mm, treatment with RFA or MWA. Radiological response was evaluated with multiphasic contrast-enhanced Computed Tomography or Magnetic Resonance Imaging at 5-7 weeks after thermal ablation. Complete response was defined when no vital tissue was detected after treatment.
Overall, 251 HCC patients were included in this study; 81 patients were treated with MWA and 170 with RFA. The complete response rate was similar in MWA and RFA groups (out of 331 nodules, 87.5% (91/104) were treated with MWA and 84.2% (186/221) were treated with RFA, p = 0.504). Interestingly, a subanalysis demonstrated that for 21-35 mm nodules, the probability to achieve a complete response using MWA was almost 5 times higher than for RFA (OR = 4.88, 95% CI 1.37-17.31, p = 0.014). Moreover, recurrence rate in 21-35 mm nodules was higher with RFA with respect to MWA (31.9% versus 13.5%, p = 0.019). Overall survival was 80.4% (45/56) when treated with MWA and 62.2% (56/90) when treated with RFA (p = 0.027). No significant difference was observed between MWA and RFA treatment in the 15-20 mm nodules group.
This study showed that MWA is more efficient than RFA in achieving complete response in HCC nodules with 21 to 35 mm diameter.
摘要：
关于经皮微波消融（MWA）或射频消融（RFA）在极早期或早期（BCLA0或A）肝细胞癌（HCC）中的优越性，文献中提供了对比数据。
主要结果是比较RFA和MWA在早期和非常早期HCC肝硬化患者中实现完全反应的功效。次要结果是评估总生存率和复发率。
回顾,观察,进行单中心研究.纳入标准为肝硬化，新诊断为单个结节的HCC，最大直径为50mm或最多三个直径为35mm的结节。用RFA或MWA治疗。在热消融后5-7周，使用多相对比增强计算机断层扫描或磁共振成像评估放射学反应。当治疗后未检测到重要组织时，定义了完全反应。
总的来说，251例HCC患者纳入本研究；81例患者接受MWA治疗，170例接受RFA治疗。MWA和RFA组的完全缓解率相似(331个结节中,87.5%(91/104)用MWA治疗,84.2%(186/221)用RFA治疗,p=0.504）。有趣的是,一项子分析表明，对于21-35毫米的结节，使用MWA获得完全缓解的概率几乎是RFA的5倍(OR=4.88,95%CI1.37-17.31,p=0.014).此外，关于MWA，RFA在21-35毫米结节中的复发率较高（31.9%对13.5%，p=0.019)。用MWA治疗时的总生存率为80.4%(45/56),用RFA治疗时的总生存率为62.2%(56/90)(p=0.027)。在15-20mm结节组中，MWA和RFA治疗之间没有观察到显着差异。
这项研究表明，在直径为21至35mm的HCC结节中，MWA比RFA更有效。
主要结果是比较RFA和MWA在早期和非常早期HCC肝硬化患者中实现完全反应的功效。次要结果是评估总生存率和复发率。
回顾,观察,进行单中心研究.纳入标准为肝硬化，新诊断为单个结节的HCC，最大直径为50mm或最多三个直径为35mm的结节。用RFA或MWA治疗。在热消融后5-7周，使用多相对比增强计算机断层扫描或磁共振成像评估放射学反应。当治疗后未检测到重要组织时，定义了完全反应。
总的来说，251例HCC患者纳入本研究；81例患者接受MWA治疗，170例接受RFA治疗。MWA和RFA组的完全缓解率相似(331个结节中,87.5%(91/104)用MWA治疗,84.2%(186/221)用RFA治疗,p=0.504）。有趣的是,一项子分析表明，对于21-35毫米的结节，使用MWA获得完全缓解的概率几乎是RFA的5倍(OR=4.88,95%CI1.37-17.31,p=0.014).此外，关于MWA，RFA在21-35毫米结节中的复发率较高（31.9%对13.5%，p=0.019)。用MWA治疗时的总生存率为80.4%(45/56),用RFA治疗时的总生存率为62.2%(56/90)(p=0.027)。在15-20mm结节组中，MWA和RFA治疗之间没有观察到显着差异。
这项研究表明，在直径为21至35mm的HCC结节中，MWA比RFA更有效。
