The effect of tumor location on long-term results of microwave ablation for early-stage hepatocellular carcinoma
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INTERVENTIONAL RADIOLOGY
The effect of tumor location on long‑term results of microwave ablation for early‑stage hepatocellular carcinoma Jian‑ping Dou1 · Zhi‑yu Han1 · Zhi‑gang Cheng1 · Fang‑yi Liu1 · Xiao‑ling Yu1 · Jie Yu1 · Ping Liang1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background To analyze the influence of tumor location, including tumor adjacency and located segments on long-term survival outcomes for patients with solitary hepatocellular carcinoma (HCC) after microwave ablation (MWA). Methods This retrospective study evaluated 850 patients. The hepatic segments where the tumor is located, tumor adjacency (important tissues adjacent to tumor) and other clinical characteristics were collected. Overall survival (OS), local tumor progression (LTP) and disease-free survival (DFS) were compared and analyzed. Influence of tumor location was evaluated by multi-models and the effect of adjacency for OS, LTP, and DFS in different segments was analyzed by stratification analysis. Results The OS, LTP, and DFS rates were similar in different hepatic segments, so were in high risk and safe locations. In multi-models, HCC in segment 8 showed lower death rate of 43% than that in segment 2 (HR 0.57; P = 0.01) and tumors in segment 6 seemed to have lower LTP rate. Tumors in high-risk locations were risk factors for OS, LTP, and DFS compared with tumors in safe locations, but all differences were not significant in different models. The effects of tumor adjacency on survival outcomes among subgroups of segments were limited. Conclusion The tumor adjacency was not a prognostic factor of survival outcomes for patients with solitary tumors after MWA, but tumors in segment 8 seemed to better OS rate than tumors in other segments. Keywords Tumor location · Ablation · Hepatocellular carcinoma · Survival outcomes
Introduction Liver cancers are the fourth most common cause of cancerrelated death. Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers [1]. Substantial progress has been made for HCC therapies [2, 3]. As one of curative therapies, thermal ablation has gained lots of attention due to the clinical benefits of fewer complications, high repeatability and quick recover [4]. Therapeutic outcomes differ in different studies and lots of factors might influence the thermal outcomes. Tumor size is one of the key factors correlated with the extent of tumor necrosis. It is commonly recommended tumor size smaller than 3 cm for curative radiofrequency * Jie Yu yu‑[email protected] * Ping Liang [email protected] 1
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
(RF) ablation for HCC, while studies have raised up to break the 3 cm barrier to 5 cm with the development of microwave ablation (MWA) [4, 5].Tumor location is another potential factor influencing therapeutic outcomes of thermal ablation. Debates exist whether tumor in high-risk locations will influence the local control and oncol
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