Comparison of microwave ablation and transcatheter ablation and transcatheter arterial chemoembolization in the treatment of early hepatocellular carcinoma

Background: Patients with cirrhosis and early stage hepatocellular carcinoma (HCC) may not be candidates for surgical resection due to liver dysfunction. Two common alternative therapies to treat HCC are transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA). We compared outcomes between HCC patients within Milan criteria after initial treatment with these two therapies. Methods: The records of 58 patients diagnosed with HCC within Milan criteria and treated initially with either TACE or MWA were reviewed. Pre-treatment factors, perioperative outcomes and survival were compared between groups. Results: There were 36 patients treated with MWA and 22 with TACE. Pre-treatment AFP levels were higher in the TACE group. Treatment with MWA was associated with progression-free survival (PFS) of 17.1 months versus 8.9 months after TACE (p=0.56). Disease- specific survival (DSS) was higher in the MWA group (median not reached) than the TACE group (32.0 months, p=0.047). Nine (15.5%) patients in this cohort went on to receive liver transplantation. Conclusions: Treatment with either MWA or TACE for patients with cirrhosis and unresectable HCC within Milan criteria is generally safe and initially effective, but recurrence and eventual death due to HCC or cirrhosis is common. These therapies should be a bridge to transplantation for all appropriate candidates.

Key-words:

Hepatocellular carcinoma (HCC) - Transcatheter arterial chemoembolization (TACE) - Microwave ablation (MWA) - Hepatic cirrhosis - Milan criteria

Publikationsverlauf

Eingereicht: 16. August 2013

Angenommen: 05. September 2013

Artikel online veröffentlicht:
07. Juli 2022