Comparison of radiofrequency and microwave ablation and identification of risk factors for primary treatment failure and local progression.

Abstract:

PURPOSE:To compare percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of Hepatocellular carcinoma (HCC) and to identify risk factors for treatment failure and local progression. METHODS:145 unique HCC [87 (60%) RFA, 58 (40%) MWA] were retrospectively reviewed from a single tertiary medical center. Adverse events were classified as severe, moderate, or mild according to the Society of Interventional Radiology Adverse Event Classification system. Primary and secondary efficacy, as well as local progression, were determined using mRECIST. Predictors of treatment failure and time to local progression were analyzed using generalized estimating equations and Cox regression, respectively. RESULTS:Technical success was achieved in 143/145 (99%) HCC. There were 1 (0.7%) severe and 2 (1.4%) moderate adverse events. Of the 143 technically successful initial treatments, 136 (95%) completed at least one follow-up exam. Primary efficacy was achieved in 114/136 (84%). 9/22 (41%) primary failures underwent successful repeat ablation, so secondary efficacy was achieved in 128/136 (90%) HCC. Local progression occurred in 24 (19%) HCC at a median of 25 months (95% CI = 19-32 months). There was no difference in technical success, primary efficacy, or time to local progression between RFA and MWA. In HCC treated with MWA, same-day biopsy was associated with primary failure (RR = 9.0, 95% CI: 1.7-47, P = 0.015), and proximity to the diaphragm or gastrointestinal tract was associated with local progression (HR = 2.40, 95% CI:1.5-80, P = 0.017). CONCLUSION:There was no significant difference in primary efficacy or time to local progression between percutaneous RFA and MWA.

journal_name

Clin Imaging

journal_title

Clinical imaging

authors

McDevitt JL,Collard MD,Murphy RP,Sutphin PD,Yopp AC,Singal AG,Kalva SP

doi

10.1016/j.clinimag.2020.06.014

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

146-151

eissn

0899-7071

issn

1873-4499

pii

S0899-7071(20)30218-7

journal_volume

67

pub_type

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