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  • Title: Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation.
    Author: Simo KA, Sereika SE, Newton KN, Gerber DA.
    Journal: J Surg Oncol; 2011 Dec; 104(7):822-9. PubMed ID: 21520094.
    Abstract:
    BACKGROUND: Thermal ablation techniques are increasingly important in the search for improved locoregional therapy of hepatocellular carcinoma (HCC) in patients with cirrhosis. This study reports the largest US series using laparoscopic-assisted microwave ablation (Lap-MWA) with a 915-MHz generator for HCC and compares it with a contemporary laparoscopic-assisted radiofrequency ablation (Lap-RFA) experience. METHODS: Thirty-five patients with HCC underwent laparoscopic-assisted ablation utilizing either MWA or RFA. Medical records, radiographic imaging, and histology were reviewed and outcomes analyzed. RESULTS: Twenty-two patients underwent Lap-RFA (27 tumors) and 13 received Lap-MWA (15 tumors). Average ablation volumes were similar for Lap-RFA and Lap-MWA at 23.43 and 28.99 cm(3), respectively (=0.69). Average operative times for Lap-RFA were 149 ± 35 min versus 112 ± 40 min with Lap-RFA (P = 0.004). Mean follow-up was 19 months in the Lap-RFA group: 50% alive without evidence of disease, 9% alive with disease, 36% deceased and 5% lost to follow-up. Mean follow-up in the Lap-MWA group was 7 months: 54% alive without evidence of disease, 31% alive with disease and 15% deceased. CONCLUSION: Lap-MWA is a safe and efficacious locoregional therapy for HCC which achieves outcomes comparable to Lap-RFA. Shorter operative times were realized with this modality and complete coagulative necrosis was confirmed histologically on explanted livers.
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