Evaluation of the efficacy and postoperative outcomes of hydrodissection-assisted microwave ablation for subcapsular hep
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INTERVENTIONAL RADIOLOGY
Evaluation of the efficacy and postoperative outcomes of hydrodissection‑assisted microwave ablation for subcapsular hepatocellular carcinoma and colorectal liver metastases Chong Liu1 · Jintong He1 · Tian Li1 · Duo Hong1 · Hongying Su1 · Haibo Shao1 Received: 15 July 2020 / Revised: 8 October 2020 / Accepted: 12 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To explore the effect of hydrodissection assisted percutaneous microwave ablation (MWA) on the primary technique efficacy (PTE) and local tumor progression (LTP) of subcapsular hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM). Methods A retrospective review of 135 patients with 181 hepatic subcapsular HCC and CRLM that underwent MWA with (hydrodissection group) and without the use of hydrodissection (control group). The PTE, cumulative LTP rate, and postoperative complications were compared between the two groups. Results Amongst the 135 patients with 181 tumors, 60 patients with 72 tumors were in the hydrodissection group and 75 patients with 109 tumors were in the control group. The PTEs were 97.2% and 85.3% in hydrodissection and control groups, respectively (P = 0.019). Multivariate analysis showed that hydrodissection significantly improved the PTE of MWA [odds ratio (OR) 0.147; 95% confidence interval (CI) 0.031–0.703; P = 0.016). Among the tumors which achieved complete response at the first (1 month) follow-up, the overall LTP rates were 8.6% (6/70) and 11.8% (11/93) in the hydrodissection and control groups, respectively. The 1- and 2-year cumulative LTP rates were 3.0% and 5.0% for the hydrodissection group and 6.8% and 13.5% in the control group, respectively (P = 0.391). No significant differences were observed in major postoperative complications between the two groups. Conclusion Hydrodissection-assisted MWA had a significantly higher PTE than MWA alone in hepatic subcapsular HCC and CRLM. Hydrodissection did not significantly impact the cumulative LTP rate or the incidence of postoperative complications. Keywords Hepatocellular carcinoma · Colorectal liver metastasis · Subcapsular tumors · Microwave ablation · Hydrodissection
Introduction Previous studies have shown that thermal ablation of subcapsular hepatic malignancies confers a higher risk of residual tumor and local progression [1–3]. In addition, complications, such as abdominal bleeding, gastrointestinal injury, and needle tract implantation, occurred more frequently in the subcapsular hepatic region [1–3]. Recently, hydrodissection assisted tumor ablation has been shown to be safe and * Haibo Shao [email protected] 1
Department of Radiology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China
effective in preventing injury to non-target critical structures and reducing postoperative complications, thereby expanding the indications of image-guided percutaneous tumor ablation [4–8]. Hydrodissection consists of injecting water
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