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. 2014 Nov;16(11):979-86.
doi: 10.1111/hpb.12264. Epub 2014 Apr 18.

Laparoscopic microwave ablation in patients with hepatocellular carcinoma: a prospective cohort study

Umberto Cillo  1 , Giulia Noaro, Alessandro Vitale, Daniele Neri, Francesco D'Amico, Enrico Gringeri, Fabio Farinati, Valter Vincenzi, Mario Vigo, Giacomo Zanus; HePaTIC Study Group
Collaborators, Affiliations

Laparoscopic microwave ablation in patients with hepatocellular carcinoma: a prospective cohort study

Umberto Cillo et al. HPB (Oxford). 2014 Nov.

Abstract

Objectives: There are no prospective studies of laparoscopic microwave (MW) ablation in patients with hepatocellular carcinoma (HCC). The aim of this study was to demonstrate the safety and efficacy of laparoscopic MW ablation.

Methods: A prospective study group of consecutive HCC patients considered ineligible for liver resection and/or percutaneous ablation was conducted from December 2009 to December 2010. Short-term (3-month) outcomes included a centralized revision of radiological response, mortality and morbidity. Mid-term (24-month) outcomes included time to recurrence in the study group compared with that in a cohort of consecutive patients treated with laparoscopic radiofrequency (RF) ablation using propensity score analysis.

Results: A total of 42 patients were enrolled. Their median age was 64 years; 67% were positive for hepatitis C virus; 33% were of Child-Pugh class B status; the median tumour diameter was 2.5 cm, and 48% of patients had multinodular HCC. In 47 of 50 (94%) nodules treated with MW ablation, a complete radiological response was observed at 3 months. There was no perioperative mortality. The overall morbidity rate was 24%. The 2-year survival rate was 79% and the 2-year recurrence rate was 55%. Using propensity score analysis (in 28 MW ablation patients and 28 RF ablation controls), 2-year recurrence rates were 55% in the MW ablation group and 77% in the control group (P = 0.03).

Conclusions: Laparoscopic MW ablation is a safe and effective therapeutic option for selected HCC patients who are ineligible for liver resection and/or percutaneous ablation.

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Figures

Figure 1
Figure 1
Kaplan–Meier curves showing survival in unmatched cohorts of hepatocellular carcinoma patients submitted to laparoscopic microwave (MW) or radiofrequency (RF) ablation (log-rank test, P = 0.0089)
Figure 2
Figure 2
Kaplan–Meier curves showing recurrence in unmatched cohorts of hepatocellular carcinoma patients submitted to laparoscopic microwave (MW) or radiofrequency (RF) ablation (log-rank test, P = 0.0162)
Figure 3
Figure 3
Kaplan–Meier curves showing survival in propensity score-matched cohorts of hepatocellular carcinoma patients submitted to laparoscopic microwave (MW) or radiofrequency (RF) ablation (log-rank test, P = 0.2056)
Figure 4
Figure 4
Kaplan–Meier curves showing recurrence in propensity score-matched cohorts of hepatocellular carcinoma patients submitted to laparoscopic microwave (MW) or radiofrequency (RF) ablation (log-rank test, P = 0.0354)
See this image and copyright information in PMC

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