Microwave ablation of hepatic tumors with a third generation system: loco‑regional efficacy in a prospective cohort study with intermediate term follow-up.
OBJECTIVE
To evaluate the safety and intermediate-term efficacy of percutaneous microwave ablation (MWA) in primary and secondary liver tumors using a third generation MWA device, under ultrasound guidance.


METHODS
Sixty-two patients (median age 74 years, 73 % males) with 69 liver tumors were enrolled in this prospective observational study. Forty-seven patients (76 %) had hepatocellular carcinoma (HCC) and 15 (24 %) metastases. Median follow-up was 3.6 years.


RESULTS
Median tumor diameter at contrast enhanced computed tomography was 23 mm (I-III quartiles, 18 - 31 mm). All procedures were performed percutaneously using a 2.45 GHz generator. Median ablation time was 10 minutes (I-III quartiles, 10 - 14 minutes). A single percutaneous antenna insertion was performed for 56/69 (81 %) of the tumors. Technical success was obtained in all tumors. Primary efficacy at 24 hours was achieved in 68/69 (99 %) tumors. The overall one-year cumulative local tumor progression rate was 15.1 % (95 % CI, 7.7 - 24.8 %) with no significant difference between HCC and metastases (p = 0.26). There was one procedure-related mortality (1.6 %) and one major bleeding (1.6 %).


CONCLUSIONS
Microwave ablation is a valid option for thermal ablation of HCC and liver metastases with comparable complication rate to other local ablative procedures.
Department of Radiology, San Gerardo Hospital, Monza, Italy.
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Meloni
Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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Galimberti
Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Germany.
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Dietrich
Depart of Internal Medicine, Ospedale "M.O.A Locatelli" Piario (BG), Italy.
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Lazzaroni
Division of Image-Guided Therapy and Interventional Oncology, Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel.
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Goldberg
Department of Radiology, San Gerardo Hospital, Monza, Italy.
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Abate
Department of Radiology, San Gerardo Hospital, Monza, Italy.
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Sironi
Department of Radiology, San Gerardo Hospital, Monza, Italy.
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Andreano
D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation* / Q000401:mortality / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality* / Q000517:prevention & control*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome