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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(01): 22-28
DOI: 10.1055/s-0041-1723050
Original Article

Comparative Analysis of Radiofrequency Ablation and Microwave Ablation for Critically Located Hepatocellular Carcinomas Smaller than 5 cm

Ravindran Ramalingam   #
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Amar Mukund    #
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Karan Manoj Anandpara
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Yashwant Patidar
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Shiv Kumar Sarin
2   Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Purpose To compare the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) for hepatocellular carcinomas (HCC) smaller than 5 cm in critical locations.

Methods Single-center retrospective study of all patients who underwent RFA/MWA for HCC from July 2015 to Dec 2019. Critical location includes exophytic tumors, tumors ≤ 5 mm from the diaphragm, heart, gallbladder, kidney, gastrointestinal tract, and ≤ 10 mm from large vessels with caliber of ≥ 3 mm. Treatment effectiveness, local tumor progression, and complication rates were evaluated.

Results Out of 119 patients with 147 HCC nodules in critical location, 65 (M:F = 49:16; mean age–61.7) were included in RFA group and 54 (M:F =43:11; mean age–60.5) in MWA group. Mean follow-up period was 16.5 and 14.8 months, respectively. At first follow-up imaging, 66/78 tumors in RFA group and 57/69 tumors in MWA group showed complete ablation with primary treatment effectiveness rates of 84.6% and 82.6%, respectively (p = 0.741). Local tumor progression (LTP) rate was 21.8% (17/78) and 20.3% (14/69), respectively (p = 0.826). Median time to LTP was 12 and 13.5 months, respectively. Fourteen tumors in RFA group and 12 in MWA group underwent reablation with a secondary treatment effectiveness rates of 78.6% (14/17) and 83.3% (12/14), respectively (p = 0.757). Mean LTP-free survival was 37.2 and 28.1 months, respectively. The total complication rate was 36.9% and 31.5%, respectively (p = 0.535) with no major complications in both the groups.

Conclusion Our data suggest that both MWA and RFA are equally safe and effective for treating HCCs < 5 cm in critical locations.

Keywords

carcinoma - hepatocellular - radiofrequency ablation - microwave ablation

# These authors contributed equally to this work.




Publication History

Article published online:
25 January 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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