title: [Computed tomography-guided percutaneous microwave ablation for diaphragm-abutting liver tumors: assessments of safety and short-term therapeutic efficacies].
abstract: OBJECTIVE
  To assess the safety and short-term therapeutic efficacies of computed tomography (CT)-guided percutaneous microwave ablation (PMA) for diaphragm-abutting liver tumors.
  
  
  METHODS
  A total of 69 patients with 75 diaphragm-abutting liver tumors (tumor from diaphragmc ≤ 5 mm) underwent CT-guided PMA. According to the site of diaphragm-abutting lesions, they were divided into neighboring muscle group (group A) and neighboring aponeurosis group (group B); According to the size of lesions, they were divided into <2.5 cm group (group I) and ≥ 2.5 cm group (group II). The complications of intra and post-ablation within 2 weeks were recorded. They underwent contrast enhanced CT (CECT) or contrast enhanced MRI (CEMRI) at Month 1, 3 and 6 post-ablation. Then CEMRI or CECT was re-checked every 3-6 months. All patients were followed up for 12-30 months. Comparative analyses were performed for short-term therapeutic efficacies.
  
  
  RESULTS
  At Month 1 post-PMA, complete response (CR) rate was 86.7% (65/75) and incomplete response (ICR) rate 13.3% (10/75). After additional ablation, 5 lesions transformed into CR.No statistical difference in CR rate existed between groups A and B (95.0% vs 77.1%). The CR rate of group I was obviously higher than that of group II (95.0% vs 77.1%). The 1-year survival rate was 97.1%. The occurring rate of minor complications was 42.0% (29/69) and that of serious complications 2.9% (2/69).No statistical difference of occurring rates of minor complications existed between groups A and B(38.1%vs 45.5%). But the occurring rates of diaphragmatic burns, pulmonary exudation and pneumothorax had obvious statistical differences between two groups. The occurring rate of minor complications in group I was obviously lower than that of group II (30.0% vs 54.3%) and serious complications occurred in group II. Minor complications were reversible and recovered after non-special or symptomatic treatment. Two cases of serious complications improved after standard clinical treatment.
  
  
  CONCLUSIONS
  CT-guided PMA for diaphragm-abutting liver tumors is both safe and effective.However puncture route and power/time should be optimized according to tumor size and location.
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China. Email: fanweijun1964@126.com.
authors.forename: Weijun
authors.initials: W
authors.lastname: Fan
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.
authors.forename: Zilin
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.
authors.forename: Ze
authors.initials: Z
authors.lastname: Song
authors.affiliation: Imaging & Interventional Center, Cancer Center & State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou 510060, China.
authors.forename: Han
authors.initials: H
authors.lastname: Qi
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome