Microwave ablation versus laparoscopic resection as first-line therapy for solitary 3-5-cm HCC

被引：71

作者：

Wang, Zhen ^{[1
,2
,3
]}

Liu, Miao ^{[4
]}

Zhang, De-zhi ^{[5
]}

Wu, Song-song ^{[6
]}

Hong, Zhi-xian ^{[7
,8
]}

He, Guang-bin ^{[9
]}

Yang, Hong ^{[10
]}

Xiang, Bang-de ^{[11
]}

Li, Xiao ^{[12
]}

Jiang, Tian-an ^{[13
]}

Li, Kai ^{[14
]}

Tang, Zhe ^{[15
]}

Huang, Fei ^{[16
]}

Lu, Man ^{[17
]}

Chen, Ji-an ^{[16
]}

Lin, Yu-cheng ^{[6
]}

Lu, Xiao ^{[9
]}

Wu, Yu-quan ^{[10
]}

Zhang, Xiao-wu ^{[12
]}

Zhang, Ye-fan ^{[18
]}

Cheng, Chao ^{[13
]}

Ye, Huo-lin ^{[14
]}

Wang, Lan-tian ^{[19
]}

Zhong, Hua-ge ^{[3
]}

Zhong, Jian-hong ^{[11
]}

Wang, Lu ^{[17
]}

Chen, Miao ^{[20
]}

Liang, Fang-fang ^{[21
]}

Chen, Yi ^{[3
]}

Xu, Yan-song ^{[22
]}

Yu, Xiao-ling ^{[1
,2
]}

Cheng, Zhi-gang ^{[1
,2
]}

Liu, Fang-yi ^{[1
,2
]}

Han, Zhi-yu ^{[1
,2
]}

Tang, Wei-zhong ^{[3
]}

Yu, Jie ^{[1
,2
]}

Liang, Ping ^{[1
,2
]}

机构：

[1] Chinese Peoples Liberat Army Gen Hosp, PLA Med Coll, Dept Intervent Ultrasound, Beijing, Peoples R China

[2] Chinese Peoples Liberat Army Gen Hosp, PLA Med Coll, Med Ctr Chinese 5, Beijing, Peoples R China

[3] Guangxi Med Univ, Guangxi Clin Res Ctr CRC, Dept Gastrointestinal Surg, Canc Hosp, Nanning, Peoples R China

[4] Chinese Peoples Liberat Army Gen Hosp, Grad Sch, Beijing, Peoples R China

[5] Jilin Univ, Abdominal Ultrasound Dept, Hosp 1, Changchun, Peoples R China

[6] Fujian Med Univ, Dept Ultrasonog, Shengli Clin Med Coll, Fuzhou, Peoples R China

[7] Peoples Liberat Army Gen Hosp, PLA Med Coll, Dept Hepatobiliary Surg, Beijing, Peoples R China

[8] Peoples Liberat Army Gen Hosp, PLA Med Coll, Med Ctr 5, Beijing, Peoples R China

[9] Fourth Mil Med Univ, Xijing Hosp, Dept Ultrasound, Xian, Peoples R China

[10] Guangxi Med Univ, Dept Ultrasound, Affiliated Hosp 1, Nanning, Peoples R China

[11] Guangxi Med Univ, Dept Hepatobiliary Surg, Canc Hosp, Nanning, Peoples R China

[12] Chinese Acad Med Sci & Peking Union Med Coll, Dept Intervent Therapy, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China

[13] Zhejiang Univ, Affiliated Hosp 1, Dept Ultrasound Med, Sch Med, Hangzhou, Zhejiang, Peoples R China

[14] Sun Yat Sen Univ, Dept Ultrasound, Guangdong Key Lab Liver Dis Res, Affiliated Hosp 3, Guangzhou, Peoples R China

[15] Zhejiang Univ, Affiliated Hosp 4, Dept Surg, Sch Med, Yiwu, Peoples R China

[16] Guangxi Med Univ, Dept Gen Surg, Affiliated Hosp 2, Nanning, Peoples R China

[17] Univ Elect Sci & Technol China, Sichuan Canc Hosp Inst, Ultrasound Med Ctr, Sichuan Canc Ctr,Sch Med, Chengdu, Peoples R China

[18] Chinese Acad Med Sci & Peking Union Med Coll, Dept Hepatobiliary Surg, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China

[19] Zhejiang Univ, Affiliated Hosp 2, Dept Surg, Sch Med, Hangzhou, Peoples R China

[20] Guangxi Med Univ, Canc Hosp, Dept Radiol, Nanning, Peoples R China

[21] Guangxi Med Univ, Dept Med Oncol, Affiliated Hosp 1, Nanning, Peoples R China

[22] Guangxi Med Univ, Dept Emergency, Affiliated Hosp 1, Nanning, Peoples R China

来源：

HEPATOLOGY | 2022年 / 76卷 / 01期

关键词：

OPEN LIVER RESECTION; HEPATOCELLULAR-CARCINOMA; RADIOFREQUENCY ABLATION; LONG-TERM; HEPATIC RESECTION; TRIAL; HEPATECTOMY; OUTCOMES;

D O I：

10.1002/hep.32323

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims The study objective was to compare the effectiveness of microwave ablation (MWA) and laparoscopic liver resection (LLR) on solitary 3-5-cm HCC over time. Approach and Results From 2008 to 2019, 1289 patients from 12 hospitals were enrolled in this retrospective study. Diagnosis of all lesions were based on histopathology. Propensity score matching was used to balance all baseline variables between the two groups in 2008-2019 (n = 335 in each group) and 2014-2019 (n = 257 in each group) cohorts, respectively. For cohort 2008-2019, during a median follow-up of 35.8 months, there were no differences in overall survival (OS) between MWA and LLR (HR: 0.88, 95% CI 0.65-1.19, p = 0.420), and MWA was inferior to LLR regarding disease-free survival (DFS) (HR 1.36, 95% CI 1.05-1.75, p = 0.017). For cohort 2014-2019, there was comparable OS (HR 0.85, 95% CI 0.56-1.30, p = 0.460) and approached statistical significance for DFS (HR 1.33, 95% CI 0.98-1.82, p = 0.071) between MWA and LLR. Subgroup analyses showed comparable OS in 3.1-4.0-cm HCCs (HR 0.88, 95% CI 0.53-1.47, p = 0.630) and 4.1-5.0-cm HCCs (HR 0.77, 95% CI 0.37-1.60, p = 0.483) between two modalities. For both cohorts, MWA shared comparable major complications (both p > 0.05), shorter hospitalization, and lower cost to LLR (all p < 0.001). Conclusions MWA might be a first-line alternative to LLR for solitary 3-5-cm HCC in selected patients with technical advances, especially for patients unsuitable for LLR.

引用

页码：66 / 77

页数：12

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