Efficacy and safety of targeted immune drugs conversion microwave ablation in the treatment of hepatocellular carcinoma: a retrospective cohort study

Abstract

Objective To evaluate the effectiveness and safety of target-immune drug-converted microwave ablation (MWA) companred to MWA alone for treating hepatocellular carcinoma (HCC). Methods Retrospectively analyzed the clinical data of 257 patients with hepatocellular carcinoma (HCC) who received either targeted immune drug conversion with microwave ablation (Drug + MWA) or microwave ablation alone (MWA) from January 2022 to March 2023, employing the propensity score matching (PSM) method to mitigate the impact of potential confounding factors. The incidence of perioperative complications was compared between the two groups, and univariate as well as multivariate logistic regression analyses were performed to evaluate these complications. Additionally, Kaplan-Meier curves were utilized to evaluate the tumor control effect between the two groups. Results Drug + MWA group and MWA group included 60 patients respectively. The rates of perioperative complications were similar between the two groups (all p > 0.05). Multivariate logistic regression analysis indicated that age and tumor size were positively correlated with the occurrence of perioperative complications associated with MWA (p < 0.05). The most common complications included fever, secondary infection, and electrolyte imbalance, with independent risk factors identified as tumor size, serum albumin, and gender, respectively. Compared to the MWA group, the Drug + MWA group exhibited significantly reduced 1-year intrahepatic tumor progression (1.7% vs. 13.3%, p = 0.015) and local tumor progression rates (1.7% vs. 11.7%, p = 0.028) compared to the MWA group. Conclusions Compared with MMW therapy alone, target-immune drug conversion into MWA does not increase the risk of perioperative complications, and has better control over intrahepatic and local tumor progression.