Percutaneous microwave ablation of exophytic tumours in hepatocellular carcinoma patients: Safe or not?

摘要

Abstract Background & Aims To explore the long‐term outcomes and safety of ultrasound‐guided percutaneous microwave ablation ( MWA ) of exophytic tumours in hepatocellular carcinoma ( HCC ) patients. Methods One hundred and thirty‐two patients with subcapsular HCC were enrolled in this retrospective study. These patients were divided into the exophytic group (n=71) and non‐exophytic group (n=61) according to the location of the tumour(s). A special technology of puncture and ablation was performed to treat the exophytic tumours. The local tumour progression ( LTP ), progression free survival ( PFS ) and overall survival ( OS ) were analysed using Kaplan‐Meier and Log‐rank tests. Results Sixty‐nine of 71 exophytic tumours and 60 of 61 subcapsular tumours were completely ablated. The complete ablation rates were 97.2% and 98.4% respectively. The follow‐up periods ranged from 6 to 62?months with a median of 31?months in the exophytic group, and ranged from 5 to 61?months, with a median of 27?months in the non‐exophytic group. The 1‐, 3‐ and 5‐year cumulative LTP rates were 2.4%, 12.3%, 18.4% and 5.1%, 12.0%, 17.8% in the exophytic and non‐exophytic groups respectively ( P =.733). The 1‐, 3‐ and 5‐year OS rates were 100%, 75.7%, 52.9% and 95.0%, 73.8%, 61.5% in the exophytic group and non‐exophytic group respectively ( P =.980). There was no procedure‐related mortality or major complication. Conclusion Ultrasound‐guided percutaneous MWA is safe and effective for exophytic tumours in HCC patients. Treated by MWA , the HCC patients with exophytic tumours can get the similar local response and long‐term outcome to those with non‐exophytic subcapsular tumours.