Ultrasound-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: oncologic outcomes and advanced assistive technology

Abstract

Purpose: To assess the oncologic outcomes of the hepatocellular carcinoma (HCC) patients in challenging locations (CLs) underwent ultrasound-guided percutaneous microwave ablation (US-PMWA) and the efficacy and safety of the advanced assistive technology (AAT). Materials and methods: Data for 489 treatment-naïve patients with HCC who met Milan criteria and subsequently underwent US-PMWA were reviewed from March 2012 to November 2016. According to the distance (<5 mm) between the tumor and surrounding structures, the patients were divided into two groups: a CL group and a non-CL group. Regarding MWA assisted by AAT, the CL group was further subdivided into two groups: an AAT group and a non-AAT group. Technique effectiveness, complications and survival outcomes (i.e., overall survival [OS] and recurrence-free survival [RFS]) were compared between CL and non-CL groups. Local tumor progression (LTP) was compared between AAT and non-AAT groups. Results: Technique effectiveness and complications in the CL group were similar to those in the non-CL group (p =.873 and p =.828, respectively). The OS and RFS in six types of CL groups were comparable with those in non-CL group (p =.131–.117) including adjacent vital structures, gallbladder, hepatic hilar regions, major vessels, diaphragm and capsule, respectively. The LTP rates in the AAT group were significantly higher than those in the non-AAT group (p =.001). Conclusions: US-PMWA assisted by AAT to treat HCC lesions in CLs was safe and effective; also, this technique had comparable success and survival outcomes with those of patients in non-CL.