Period-Dependent Survival Benefit of Percutaneous Microwave Ablation for Hepatocellular Carcinoma: A 12-Year Real-World, Multicentric Experience.

Autor:	Yu J; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Cheng ZG; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Han ZY; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Liu FY; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Zheng RQ; Department of Medical Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China., Cheng W; Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin City, China., Wei Q; Department of Ultrasound, The Second Hospital of Nanjing, Nangjing, China., Yu SY; Department of Wuhan University of Science and Technology, Tianyou Hospital, Wuhan, China., Li QY; Department of Ultrasound, Puyang Hospital of Traditional Chinese Medicine of Henan Province, Puyang, China., He GZ; Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, China., Luo YC; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Yu XL; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China., Liang P; Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China.
Jazyk:	angličtina
Zdroj:	Liver cancer [Liver Cancer] 2022 Jan 28; Vol. 11 (4), pp. 341-353. Date of Electronic Publication: 2022 Jan 28 (Print Publication: 2022).
DOI:	10.1159/000522134
Abstrakt:	Introduction: Although microwave ablation (MWA) is a promising technique for hepatocellular carcinoma (HCC) treatment, its 10-year efficacy is unknown. Objective: The objective of the study was to assess whether the advances in MWA for HCC translated into a real-world survival benefit. Methods: 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. Results: 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 >3.0-cm HCC ( p < 0.001). Local tumor progression (LTP) showed no period-dependent advance, with >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 ( p < 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). Conclusions: 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. (Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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