Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success.

Autor:	Pausch AM; Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany.; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland., Ghali T; Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany., Wertheimer T; Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053 Regenburg, Germany., Zeman F; Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany., Mueller K; Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany., Doppler MC; Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany., Einspieler I; Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany., Beyer LP; Department of Diagnostic and Interventional Radiology, Klinikum Ernst von Bergmann, 14467 Potsdam, Germany., Schleder S; Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany., Stroszczynski C; Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany., Luerken L; Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany.
Jazyk:	angličtina
Zdroj:	Tomography (Ann Arbor, Mich.) [Tomography] 2022 Dec 26; Vol. 9 (1), pp. 50-59. Date of Electronic Publication: 2022 Dec 26.
DOI:	10.3390/tomography9010005
Abstrakt:	Background: Microwave ablation (MWA) has gained relevance in the treatment of hepatic malignancies and especially in hepatocellular carcinoma (HCC), and it is an important alternative to surgery. The purpose of the study was to evaluate whether the minimal ablative margin (MAM) or the initial tumor size has a greater effect on the success of stereotactic MWA of HCC regarding the time to local tumor progression (LTP) and overall survival (OS). Methods: 88 patients, who received stereotactic MWA of 127 tumor lesions with a curative intention were included in this single-center, retrospective study. The MAM was evaluated in a side-by-side comparison of pre- and post-ablative, contrast-enhanced slice imaging. A Cox proportional hazard model with a frailty term was computed to assess the influence of the MAM and the maximum tumor diameter on the time to LTP and the OS. Results: The maximum tumor diameter was identified as a significant positive predictor for LTP (hazard ratio 1.04, 95% CI 1.00-1.08, p = 0.03), but it was not a significant positive predictor for the OS ( p = 0.20). The MAM did not have a significant influence on LTP-free survival ( p = 0.23) and OS ( p = 0.67). Conclusion: For the successful stereotactic MWA of HCC, the MAM and maximum tumor diameter might not have an influence on the OS, but the maximum tumor diameter seems to be an independent predictor of the time to LTP.
Databáze:	MEDLINE
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