Comparison between percutaneous and laparoscopic microwave ablation of hepatocellular carcinoma

Corte, Angelo Della; Ratti, Francesca; Monfardini, Lorenzo; Marra, Paolo; Gusmini, Simone; Salvioni, Marco; Venturini, Massimo; Cipriani, Francesco; Aldrighetti, Luca; Cobelli, Francesco De

doi:10.1080/02656736.2020.1769869

Cited by 24 publications

(16 citation statements)

References 25 publications

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“…In terms of comparing surgical MWA, only the laparoscopic approach ensured a good RF rate. We believe that these results might be due to the fact that smaller-sized CRLM were treated using the laparoscopic approach (10 mm vs. 22.8 mm in an open approach) [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Mimmo

Pegoraro

Rhaiem

et al. 2022

Cancers

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(1) Background: colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancer; however, few patients are fit for curative surgery. Microwave ablation (MWA) showed promising outcomes in this cohort of patients. This systematic review and pooled analysis aimed to analyze the oncological results of MWA for CRLM. (2) Methods: Following PRISMA guidelines, PubMed, Scopus, EMBASE, Google Scholar, Science Direct, and the Wiley Online Library databases were searched for reports published before January 2021. We included papers assessing MWA, treating resectable CRLM with curative intention. We evaluated the reported MWA-related complications and oncological outcomes as being recurrence-free (RF), free from local recurrence (FFLR), and overall survival rates (OS). (3) Results: Twelve out of 4822 papers (395 patients) were finally included. Global RF rates at 1, 3, and 5 years were 65.1%, 44.6%, and 34.3%, respectively. Global FFLR rates at 3, 6, and 12 months were 96.3%, 89.6%, and 83.7%, respectively. Global OS at 1, 3, and 5 years were 86.7%, 59.6%, and 44.8%, respectively. A better FFLR was reached using the MWA surgical approach at 3, 6, and 12 months, with reported rates of 97.1%, 92.7%, and 88.6%, respectively. (4) Conclusions: Surgical MWA treatment for CRLM smaller than 3 cm is a safe and valid option. This approach can be safely included for selected patients in the curative intent approaches to treating CRLM.

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Section: Discussionmentioning

confidence: 99%

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Mimmo

Pegoraro

Rhaiem

et al. 2022

Cancers

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“…Similarly, our study also shows that the site of recurrence is commonly associated with the ablation margins. When MWA is used for liver cancer, recurrence also occurred near the ablation area [5,14]. It's believed to be due to the presence of an in ltrating area around the HAE lesion, which has characteristics of invasive growth similar to that of malignant tumors [15].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Deng

Wang

et al. 2021

Preprint

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BackgroundMicrowave ablation (MWA) is a popular therapy for liver malignant tumor in recent years. Few studies have been conducted on its use in the treatment of hepatic alveolar echinococcosis (HAE). The study aims to evaluate the efficacy and safety of MWA in the treatment of HAE.MethodsThis study analyzed the data of 45 patients (mean age,38 ±2 years; 24 males) diagnosed with HAE and underwent MWA treatment between June 2014 to December 2019. The patients after MWA were examined by CT or MRI to determine whether the lesions were relapsed and to evaluate the therapeutic effect of MWA. The safety of MWA was evaluated by monitoring postoperative complications. Clinical data, such as patient demographics, imaging features of the lesions, relevant findings of laboratory tests before and after ablation, and information related to ablation, were collected and analyzed. Paired-sample t tests and paired-sample Wilcoxon signed-rank tests were used to compare relevant laboratory indicators before and after MWA. ResultsMWA was applied to 57 HAE lesions in 45 patients. The median size of lesions was 3.42 cm (IQR2.85-4.41). The rate of complete ablation was 100% (57/57). The median follow-up time was 32 months (IQR 23–48.5). The recurrence rate was 13% (6/45), and the median time of recurrence was 22 months. The rate of minor complications was 11.1% (5/45), and there were no major complications and deaths. Compared to preoperative, ALB, RBC, HBG, and PLT were decreased (p<0.001); ALT, TB, DB, and WBC were increased (p<0.001); and no statistically difference in PT, APTT, and INR (p＞0.05).ConclusionsMWA is a safe and effective way to cure HAE. Meanwhile, it provides a new option and a new way of thinking about the treatment modality for patients with lesions ≤ 5 cm in diameter.

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“…Some studies have indeed reported a lower complication rate and shorter length of stay for laparoscopic compared with percutaneous ablations [37]. One study also reported comparable local tumor progression rates [38].…”

Section: Laparoscopic Approach For Local Ablation Therapymentioning

confidence: 97%

Laparoscopic Approach for the Treatment of Hepatocellular Carcinoma

Cipriani

Aldrighetti

2022

Hepatocellular Carcinoma

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Laparoscopic liver resection (LLR) was born in 1991 and gradually expanded during the following thirty years [1]. Even extremely complex procedures are performed in centers with adequate experience [2,3].Curative treatments for hepatocellular carcinoma (HCC) include liver resection (LR) and local ablation therapy, which can now be performed using the laparoscopic technique. Moreover, laparoscopy is increasingly being used to expand the indications for surgical treatment for HCC patients, being able to overcome some of the limits or issues linked to traditional open LR. Short-Term OutcomesMany studies have documented the feasibility and safety of LLR and reported advantages with respect to perioperative outcomes. Among the most frequent are the reduction of blood loss, transfusion needs, complications, and length of hospital stay, as well as earlier recovery of physiological functions and patient's autonomy. This is extremely important for HCC, since hepatectomy in cirrhosis is associated with higher complication rates than other conventional settings. In many studies focusing on HCC, the benefits of laparoscopy have been particularly evident and often associated with specific advantages. Of particular interest is the reduction of ascites, a very fearful and frequent complication in the cirrhotic patient, which laparoscopy is able to contain by avoiding large abdominal incisions, thus allowing the surgeon to preserve the parietal circulation and lymphatics and to limit the dispersion of fluids [4,5]. Also, the incidence of postoperative liver failure was shown to be reduced by many studies F. Cipriani (*) • L.

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Comparison between percutaneous and laparoscopic microwave ablation of hepatocellular carcinoma

Cited by 24 publications

References 25 publications

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Microwave Ablation for Colorectal Liver Metastases: A Systematic Review and Pooled Oncological Analyses

Effectiveness and Safety of Ultrasound-guided Percutaneous Microwave Ablation for Hepatic Alveolar Echinococcosis

Laparoscopic Approach for the Treatment of Hepatocellular Carcinoma

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