In:
Liver Cancer, S. Karger AG, Vol. 11, No. 4 ( 2022), p. 341-353
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Although microwave ablation (MWA) is a promising technique for hepatocellular carcinoma (HCC) treatment, its 10-year efficacy is unknown. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 The objective of the study was to assess whether the advances in MWA for HCC translated into a real-world survival benefit. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This retrospective study included 2,354 patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 to B from 5 hospitals, with at least 2 years of follow-up for all the patients. Recurrence and survival were analyzed using the Kaplan-Meier method with time-period stratification. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 5,326 HCCs (mean diameter, 2.9 cm ± 1.2) underwent 4,051 sessions of MWA with a median follow-up of 61.3 (0.6–169.5 range) months during 3 periods (2007–2010, 2011–2014, and 2015–2018). Technical success was achieved in 5,194 (97.5%) tumors with significant improvement over time, especially for & #x3e;3.0-cm HCC ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Local tumor progression (LTP) showed no period-dependent advance, with & #x3e;3.0-cm HCC and perivascular location being the risk factors for LTP. The median intrahepatic metastasis time was 27.6 (95% confidence interval [CI]: 25.2–28.8) months, with 5- and 10-year occurrence rates of 68.8% and 79.4%, respectively. The 5- and 10-year overall survivals were 63.9% and 41.1%, respectively, and BCLC stage 0, A, and all B patients showed an observable survival improvement over time ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). The median disease-free survival time increased from 19.4 (95% CI: 16.5–22.6) months in 2007–2010 to 28.1 (95% CI: 25.9–32.3) months in 2015–2018. The improved survival for early recurrent (≤2 years) patients was period-dependent, as verified by Cox regression analyses. The major complications rate per procedure was 3.0% (122/4,051). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 These real-world data show that MWA provided an upward trend in survival for HCC patients with BCLC stage 0–B over a 12-year follow-up period. An encouraging clear survival benefit in early recurrent patients was also observed.
Type of Medium:
Online Resource
ISSN:
2235-1795
,
1664-5553
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
2666925-0
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