title: Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation.
abstract: OBJECTIVE
  To evaluate the outcomes of patients with medium-sized hepatocellular carcinoma (HCC) who underwent percutaneous microwave ablation (MWA).
  
  
  METHODS
  We retrospectively reviewed all patients with a single medium-sized HCC who underwent percutaneous MWA from January 2010 to January 2013. Technical success, technical effectiveness and complications were subsequently observed. Survival curves were constructed using the Kaplan-Meier method. The Cox proportional hazards model was fitted to each variable. The relative prognostic significance of the variables for predicting overall survival rate, recurrence-free survival rate and local tumor recurrence(s) was assessed using univariate analysis. All variables with a P value < 0.20 were subjected to multivariate analysis.
  
  
  RESULTS
  The study included 182 patients (mean age, 58 years; age range: 22-86 years) with a single HCC (mean size, 3.72 ± 0.54 cm; range: 3.02-5.00 cm). The estimated technical effectiveness rate was 93% in 182 patients. The major complication rate was 2.7% (5/182), including liver abscess in 4 cases, and abdominal bleeding at the puncture site in 1 case. Thirty-day mortality rate was 0.5% (1/182). One patient died due to liver abscess-related septicemia. Cumulative recurrence-free survival and overall survival (OS) rates were 51%, 36%, 27% and 89%, 74%, 60% at 1, 2, and 3 years, respectively. Age (P = 0.017) and tumor diameter (P = 0.029) were independent factors associated with local tumor recurrence. None of the factors had a statistically significant impact on recurrence-free survival. Serum albumin level (P = 0.009) and new lesion(s) (P = 0.029) were independently associated with OS.
  
  
  CONCLUSIONS
  Percutaneous MWA is a relatively safe and effective treatment for patients with medium-sized HCC.
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Ai-Xue
authors.initials: AX
authors.lastname: Sun
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Zhi-Li
authors.initials: ZL
authors.lastname: Cheng
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Pan-Pan
authors.initials: PP
authors.lastname: Wu
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Yue-Hong
authors.initials: YH
authors.lastname: Sheng
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Xiu-Juan
authors.initials: XJ
authors.lastname: Qu
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Lu
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Cheng-Gong
authors.initials: CG
authors.lastname: Zhao
authors.affiliation: Ai-Xue Sun, Zhi-Li Cheng, Cheng-Gong Zhao, Department of General Surgery, 105 Hospital of Chinese PLA, Hefei 230031, Anhui Province, China.
authors.forename: Guo-Jun
authors.initials: GJ
authors.lastname: Qian
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*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Cox analysis; Hepatocellular carcinoma; Medium-sized tumor; Microwave ablation; Outcomes