Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: Experimental and clinical studies

摘要

Objective To prospectively compare microwave (MW) ablation using a modified internal cooled-shaft antenna with radiofrequency (RF) ablation in in vivo porcine liver and in patients with small hepatocellular carcinoma (sHCC). Methods In an animal study, MWand RF ablations using a cooled-shaft antenna or internally cooled electrode were performed in in vivo porcine liver. Coagulation diameters of both ablations were compared. For clinical study, 42 patients with sHCC were treated with MW or RF ablation. Complete ablation (CA) and local tumour progression (LTP) were compared. Results MW ablation produced significantly larger ablation zones than RF ablation in both porcine liver and sHCC with an ablated volume of 33.3±15.6 cm3 vs. 18.9±9.1 cm3 and 109.3±58.3 cm3 vs. 48.7±30.5 cm3, respectively. The CA rate was 95.5 % (21/22) for MWablation and 95.0 % (19/20) for RF ablation. In a 5.1-month follow-up, the LTP rate was 18.2 % (4/22) in the MW ablation group and 15.0 % (3/20) in the RF ablation group. Conclusion MWablation using a modified cooled-shaft antenna produces a larger ablation zone than RF ablation, with an efficacy similar to RF ablation in local tumour control. MW ablation is a safe and promising treatment of sHCC. Key Points ? Microwave ablation with a cooled-shaft antenna produces a larger ablation zone than radiofrequency ablation. ? Microwave and radiofrequency ablation showed similar local tumour control in small HCC. ? Microwave ablation seems safe and efficient for small liver cancers (<3 cm).