Comparison of percutaneous microwave ablation and surgical resection for hepatocellular carcinoma in the caudate lobe
Erpeng Qi, Shuang Zhang, Xin Li, Zhi Gang Cheng, Zhiyu Han, Jie Yu, Ping Liang, Xiaoling Yu
Abstract
Background: This study aims to compare the clinical efficacy and safety between ultrasound (US)-guided percutaneous microwave ablation (MWA) assisted with a three-dimensional (3D) visualization preoperative planning system and surgical resection (SR) for hepatocellular carcinoma (HCC) in the caudate lobe. Materials and Methods: Forty-nine patients diagnosed with caudate lobe HCC, who underwent US-guided percutaneous MWA (29 patients) or SR (20 patients), were enrolled between November 2005 and December 2018. Follow-up was performed at 1, 3, 6, 12, 18, 24, and 36 months after ablation or resection. The follow-up endpoint was recurrence or patient death. Overall survival (OS) and progression-free survival (PFS) were the primary outcomes, whereas local tumor progression (LTP), intrahepatic recurrence, and extrahepatic metastasis were the secondary ones. Results: The mean age of the two groups was 61.4 ± 9.1 (MWA) and 53.1 ± 6.8 (SR), respectively, with a significant difference (P < 0.01). There were no significant differences in OS (69.0% in the MWA group and 75.0% in the SR group) and PFS (62.1% in the MWA group and 35.3% in the SR group). LTP, intrahepatic recurrence, and extrahepatic recurrence were 6.9% (2/29), 31.0% (9/29), and 20.7% (6/29) in the MWA group and 5.0% (1/20), 60.0% (12/20), and 5.0% (1/20) in the SR group. The MWA group was more cost-effective and required less hospitalization time. No major complications were observed. Conclusions: US-guided percutaneous MWA for HCC in the caudate lobe assisted with a 3D visualization preoperative planning system is an optional treatment with less expenses and shorter hospitalization than SR.