title: Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Abdominal Transplantation, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7211, USA.
authors.forename: Kerri A
authors.initials: KA
authors.lastname: Simo
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Sereika
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Newton
authors.forename: David A
authors.initials: DA
authors.lastname: Gerber
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000295:instrumentation*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D016019:Survival Analysis; D016896:Treatment Outcome