Indications for living donor liver transplantation in patients with hepatocellular carcinoma

Clinical Results, Risk Factors, and Future Directions of Ultrasound-Guided Percutaneous Microwave Ablation for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with a relatively poor prognosis, especially for advanced HCC. With the availability of a variety of treatment options, the treatment strategies for HCC have become more and more diversified. Microwave ablation (MWA) has gradually been considered as a viable alternative to surgical resection (SR) owing to its comparable long-term survival, reduced complications, and greater preservation of hepatic parenchyma. However, clinical outcomes, tumor progression, and recurrence of HCC after MWA remain major concerns. Here, after reviewing the current therapeutic options for HCC, we focus on MWA, describing the advantages and challenges of MWA and the clinical results after treatment. We then focused on prognostic factors that influence post-ablation clinical outcomes and briefly presented the strategy of MWA for future clinical treatment.

Microwave-Assisted Ablation Improves the Prognosis of Patients With Hepatocellular Carcinoma Undergoing Liver Resection

Objective:

We evaluated microwave-assisted liver resection for hepatocellular carcinoma.

Patients and Methods:

We enrolled 79 patients in this study, and microwave ablation was used for liver resection. Patients were randomized to group A (50.6%; n = 40), liver resection without microwave ablation, or group B (49.4%; n = 39), liver resection performed using microwave ablation. Data were analyzed for statistical significance.

Results:

Of the participants enrolled, 60 were male, and the participant’s average age was 59.32 ± 10.34 years. The mean overall tumor diameter was 4.39 (2.00) cm, and this did not differ between groups. Intraoperative blood loss in group B was significantly less than that in group A (P < .001). No differences were reported between the 2 groups regarding surgical time (P = .914), postoperative morbidity (P = .718), and late postoperative complications (P = .409). Postoperative drainage volume for group B was less than that of group A on the first (P = .005) and third (P = .019) day after surgery. The time of postoperative hospitalization in group B was significantly shorter than that in group A (P < .001). Local recurrence was noted in 18.99% of cases (n = 15) in group B, which is less than that of group A (P = 0.047), while in group B distant metastasis is less but not statistically significant (P = 0.061). The 1-year and 3-year cumulative survival rates were 57% and 93.7%, respectively.

Conclusions:

The curative effects of liver resection combined with microwave ablation during operation are superior to only liver resection in the treatment of primary liver cancer.