title: Percutaneous microwave ablation of 5-6 cm unresectable hepatocellular carcinoma: local efficacy and long-term outcomes.
abstract: OBJECTIVE
  This study aims to evaluate the local efficacy and long-term outcomes of microwave ablation (MWA) for treating large unresectable hepatocellular carcinomas (HCCs).
  
  
  METHODS
  A total of 82 patients with 5-6 cm unresectable HCCs, who underwent a single MWA procedure during the period of January 2007 to July 2011, were retrospectively enrolled into this study. Percentages of technical success and complications of MWA and HCC local recurrence (LR) after MWA were determined. In addition, prognostic factors were screened and overall survival (OS) and recurrence-free survival (RFS) rates were estimated.
  
  
  RESULTS
  One-, three- and five-year OS rates in this MWA-treated cohort were 92.7, 63.4 and 41.1%, respectively; and the corresponding RFS rates were 65.9, 31.7 and 23.0%, respectively. Primary technical efficacy was 89.0% after the first round of ablation, three (3.7%) patients developed major complications, and LR rate was 20.7%. Child-Pugh classification (p < .001), tumour location (p = .049) and LR (p = .002) were independent factors associated with OS, as determined by multivariate analysis.
  
  
  CONCLUSIONS
  MWA is safe and effective for the treatment of selected large HCCs, and provides an alternative treatment option for patients with unresectable HCCs. Furthermore, the favourable local efficacy of MWA could potentially improve long-term survival.
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xu
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shen
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Neng
authors.initials: N
authors.lastname: Wang
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Panpan
authors.initials: P
authors.lastname: Wu
authors.affiliation: b Department Hepatobiliary Surgery, Division of Interventional Ultrasound , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.
authors.forename: Zhenwei
authors.initials: Z
authors.lastname: Peng
authors.affiliation: a Department of Minimal Invasion Therapy , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University of Chinese PLA , Shanghai , China.
authors.forename: Guojun
authors.initials: G
authors.lastname: Qian
keywords: Hepatocellular carcinoma; local recurrence; long-term outcome; microwave ablation