title: Efficacy and survival analysis of percutaneous radiofrequency versus microwave ablation for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a primary tumor of the liver with poor prognosis. For early stage HCC, treatment options include surgical resection, liver transplantation, and percutaneous ablation. Percutaneous ablative techniques (radiofrequency and microwave techniques) emerged as best therapeutic options for nonsurgical patients.
  
  
  OBJECTIVE
  We aimed to determine the safety and efficacy of radiofrequency and microwave procedures for ablation of early stage HCC lesions and prospectively follow up our patients for survival analysis.
  
  
  METHODS
  One Hundred and 11 patients with early HCC are managed in our multidisciplinary clinic using either radiofrequency or microwave ablation. Patients are assessed for efficacy and safety. Complete ablation rate, local recurrence, and overall survival analysis are compared between both procedures.
  
  
  RESULTS
  Radiofrequency ablation group (n = 45) and microwave ablation group (n = 66) were nearly comparable as regards the tumor and patients characteristics. Complete ablation was achieved in 94.2 and 96.1% of patients managed by radiofrequency and microwave ablation techniques, respectively (p value 0.6) with a low rate of minor complications (11.1 and 3.2, respectively) including subcapsular hematoma, thigh burn, abdominal wall skin burn, and pleural effusion. Ablation rates did not differ between ablated lesions ≤ 3 and 3-5 cm. A lower incidence of local recurrence was observed in microwave group (3.9 vs. 13.5% in radiofrequency group, p value 0.04). No difference between both groups as regards de novo lesions, portal vein thrombosis, and abdominal lymphadenopathy. The overall actuarial probability of survival was 91.6% at 1 year and 86.1% at 2 years with a higher survival rates noticed in microwave group but still without significant difference (p value 0.49).
  
  
  CONCLUSIONS
  Radiofrequency and microwave ablations led to safe and equivalent ablation and survival rates (with superiority for microwave ablation as regards the incidence of local recurrence).
authors.affiliation: Endemic Hepatogastroenterology Department, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, 11562, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Abdelaziz
authors.forename: Tamer
authors.initials: T
authors.lastname: Elbaz
authors.forename: Hend Ibrahim
authors.initials: HI
authors.lastname: Shousha
authors.forename: Sherif
authors.initials: S
authors.lastname: Mahmoud
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdelmaksoud
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nabeel
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome