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. 2015 Jun;84(6):1083-90.
doi: 10.1016/j.ejrad.2015.02.027. Epub 2015 Mar 14.

Microwave ablation of focal hepatic malignancies regardless of size: A 9-year retrospective study of 64 patients

Erica S Alexander  1 , Farrah J Wolf  2 , Jason T Machan  3 , Kevin P Charpentier  4 , Michael D Beland  5 , Jason D Iannuccilli  6 , Richard H Haas  7 , Damian E Dupuy  8
Affiliations

Microwave ablation of focal hepatic malignancies regardless of size: A 9-year retrospective study of 64 patients

Erica S Alexander et al. Eur J Radiol. 2015 Jun.

Abstract

Purpose: To retrospectively evaluate the safety and efficacy of microwave ablation (MWA) as treatment for single, focal hepatic malignancies.

Materials and methods: Institutional review board approval was obtained for this HIPAA-compliant study. From December 2003 to May 2012, 64 patients were treated with MWA for a single hepatic lesion, in 64 sessions. Hepatocellular carcinoma (HCC) was treated in 25 patients (geometric mean tumor size, 3.33-cm; 95% CI, 2.65-4.18-cm; range, 1.0-12.0-cm), metastatic colorectal cancer (CRC) was treated in 27 patients (geometric mean tumor size, 2.7-cm; 95% CI, 2.20-3.40-cm; range, 0.8-6.0-cm), and other histological-types were treated in 12 patients (geometric mean tumor size, 3.79-cm; 95% CI, 2.72-5.26-cm; range, 1.7-8.0-cm). Kaplan-Meier (K-M) method was used to analyze time event data. Chi-square and correlation evaluated the relationship between tumor size and treatment parameters.

Results: Technical success rate was 95.3% (61/64). Treatment parameters were tailored to tumor size; as size increased more antennae were used (p<0.001), treatment with multiple activations increased (p<0.028), and treatment time increased (p<0.001). There was no statistically significant relationship between time to recurrence and tumor size, number of activations, number of antennae, and treatment time. At one-year, K-M analysis predicted a likelihood of local recurrence of 39.8% in HCC patients, 45.7% in CRC metastases patients, and 70.8% in patients with other metastases. Median cancer specific survivals for patients were 38.3 months for HCC patients, 36.3 months for CRC metastases, and 13.9 months for other histological-types. Complications occurred in 23.4% (15/64) of sessions.

Conclusion: In our sample, tumor size did not appear to impact complete ablation rates or local recurrence rates for focal hepatic malignancies treated with MWA.

Keywords: Colorectal cancer; Hepatic metastasis; Hepatocellular carcinoma; Microwave ablation.

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