title: Laparoscopic microwave ablation in patients with hepatocellular carcinoma: a prospective cohort study.
abstract: OBJECTIVE
  There are no prospective studies of laparoscopic microwave (MW) ablation in patients with hepatocellular carcinoma (HCC). The aim of this study was to demonstrate the safety and efficacy of laparoscopic MW ablation.
  
  
  METHODS
  A prospective study group of consecutive HCC patients considered ineligible for liver resection and/or percutaneous ablation was conducted from December 2009 to December 2010. Short-term (3-month) outcomes included a centralized revision of radiological response, mortality and morbidity. Mid-term (24-month) outcomes included time to recurrence in the study group compared with that in a cohort of consecutive patients treated with laparoscopic radiofrequency (RF) ablation using propensity score analysis.
  
  
  RESULTS
  A total of 42 patients were enrolled. Their median age was 64 years; 67% were positive for hepatitis C virus; 33% were of Child-Pugh class B status; the median tumour diameter was 2.5 cm, and 48% of patients had multinodular HCC. In 47 of 50 (94%) nodules treated with MW ablation, a complete radiological response was observed at 3 months. There was no perioperative mortality. The overall morbidity rate was 24%. The 2-year survival rate was 79% and the 2-year recurrence rate was 55%. Using propensity score analysis (in 28 MW ablation patients and 28 RF ablation controls), 2-year recurrence rates were 55% in the MW ablation group and 77% in the control group (P = 0.03).
  
  
  CONCLUSIONS
  Laparoscopic MW ablation is a safe and effective therapeutic option for selected HCC patients who are ineligible for liver resection and/or percutaneous ablation.
authors.affiliation: Hepatobiliary Surgery and Liver Transplant Unit, University of Padua Hospital Trust, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Giulia
authors.initials: G
authors.lastname: Noaro
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.forename: Daniele
authors.initials: D
authors.lastname: Neri
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Amico
authors.forename: Enrico
authors.initials: E
authors.lastname: Gringeri
authors.forename: Fabio
authors.initials: F
authors.lastname: Farinati
authors.forename: Valter
authors.initials: V
authors.lastname: Vincenzi
authors.forename: Mario
authors.initials: M
authors.lastname: Vigo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zanus
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D057216:Propensity Score; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
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