Hong Kong Med J 2012;18:85–91 | Number 2, April 2012
Surgical ablation of hepatocellular carcinoma with 2.45-GHz microwave: a critical appraisal of treatment outcomes
KF Lee, Joyce WY Hui, YS Cheung, Jeff SW Wong, CN Chong, John Wong, Simon CH Yu, Paul BS Lai
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
OBJECTIVE. To evaluate the efficacy and safety of a new generation of 2.45-GHz microwave to ablate hepatocellular carcinoma by surgical approach.
DESIGN. Case series with prospective follow-up.
SETTING. A university teaching hospital in Hong Kong.
PATIENTS. From March 2009 to January 2011, 26 consecutive patients (19 men and 7 women) with a median age of 63 (range, 49-79) years with hepatocellular carcinoma were recruited. Five (19%) of the patients had recurrent hepatocellular carcinoma after previous treatment.
INTERVENTION. Microwave ablation for hepatocellular carcinomas (one tumour, n=24; two tumours, n=2) using a laparoscopic (n=16) or open approach (n=10).
MAIN OUTCOME MEASURES. Operative mortality and morbidity, rate of incomplete ablation, recurrence rate, and survival rate.
RESULTS. The median tumour diameter was 3.8 cm (range, 2.0-6.0 cm). Complications occurred in five (19%) of the patients; only one was ablation-related, and there was no operative mortality. One (4%) of the patients experienced incomplete ablation. Recurrent tumours were noted in 11 (42%) of the patients (5 were local, 2 were remote, and 4 were multifocal) after a median follow-up of 14 (range, 4-26) months. The failure rate for local disease control was 23%, and was 14% if patients with recurrent hepatocellular carcinoma were excluded. All but one patient survived until the time of censorship. The mean survival was 25 (standard deviation, 1) months.
CONCLUSION. This new-generation microwave technique is safe and effective for local ablation of hepatocellular carcinoma. It is a valuable treatment option for patients who are not candidates for hepatectomy.
Key words: Ablation techniques; Carcinoma, hepatocellular; Liver neoplasms; Microwaves
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