Laparoscopic‐assisted microwave ablation for hepatocellular carcinoma: Safety and efficacy in comparison with radiofrequency ablation

Simo, Kerri A.; Sereika, Stephanie E.; Newton, Kimberly N.; Gerber, David A.

doi:10.1002/jso.21933

Cited by 84 publications

(91 citation statements)

References 18 publications

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“…These findings indicate that despite a patient population of mainly cirrhotic individuals, operative MWA can be performed safely. This is underscored by multiple other series again highlighting the safety and effectiveness of operative MWA (14)(15)(16). Most important from this series, we evaluate our current results in comparison to our previously reported outcomes in 2013 (8).…”

Section: Discussionmentioning

confidence: 77%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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Background: Microwave ablation (MWA) of hepatocellular carcinoma (HCC) offers local regional treatment that can be safely and effectively performed, even in patients with advanced liver disease. We update results from our group's previous analysis of operative MWA for HCC. Results: Two hundred and nineteen patients were included with a total of 340 tumors treated with operative MWA. Median tumor size was 3.2 cm (range, 1-6 cm). Cirrhosis was present in 89.5% of patients, 60.7% had hepatitis C, and 8.2% had hepatitis B. Thirty-five point nine percent were Child-Pugh class B/C. Ninety-six point eight percent of MWA procedures were performed laparoscopically. Four deaths occurred within 30 days (1.8%). Clavien-Dindo grade III complications occurred in 3.2% of patients. Complete ablation was identified in 97.1% of tumors, with local recurrence rates of 8.5% at 10.9 months median follow up (0-80 months). Regional recurrence occurred in 34.8% of patients at 10.9 months median follow up and metastatic recurrence was seen in 8.1% of patients. One year overall survival was 80.0% and 2-year survival was 61.5%. Conclusions:We propose that laparoscopic MWA offers a low morbidity approach for treatment of HCC affording low rates of local recurrence even for patients with significant underlying liver dysfunction. This large series offers insight into outcomes of this modality as definitive treatment for patients with HCC.

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Section: Discussionmentioning

confidence: 77%

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Baker

Thompson

McKillop

et al. 2017

J. Gastrointest. Oncol.

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“…Although several studies have reported better diseasefree survival and a lower frequency of recurrence after surgical resection compared to RFA [10,11] , others report better overall survival and disease-free survival for HCC patients with multi-nodular tumours following RFA [12] . Recently, Simo et al [13] reported no difference regarding the efficacies of MWA and RFA procedures. TACE is routinely performed on HCC patients who are not eligible for surgical resection or tumour ablation techniques.…”

Section: Hepatocellular Carcinoma and The Unmet Medical Needsmentioning

confidence: 99%

Dickkopfs and Wnt/β-catenin signalling in liver cancer

Fatima¹

2011

WJCO

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Liver cancer is the fifth and seventh most common cause of cancer in men and women, respectively. Wnt/β-catenin signalling has emerged as a critical player in both the development of normal liver as well as an oncogenic driver in hepatocellular carcinoma (HCC). Based on the current understanding, this article summarizes the possible mechanisms for the aberrant activation of this pathway with specific focus on HCC. Furthermore, we will discuss the role of dickkopfs (DKKs) in regulating Wnt/β-catenin signalling, which is poorly understood and understudied. DKKs are a family of secreted proteins that comprise at least four members, namely DKK1-DKK4, which act as inhibitors of Wnt/β-catenin signalling. Nevertheless, not all members antagonize Wnt/β-catenin signalling. Their functional significance in hepatocarcinogenesis remains to be further characterized for which these studies should provide new insights into the regulatory role of DKKs in Wnt/β-catenin signalling in hepatic carcinogenesis. Because of the important oncogenic roles, there are an increasing number of therapeutic molecules targeting β-catenin and the Wnt/ β-catenin pathway for potential therapy of HCC. hepatocellular carcinoma anD the unmet meDical neeDSLiver cancer ranks the fifth most common cancer in men and the second leading cause of cancer-related death. In women, it is the seventh most frequent cancer and sixth leading cause of cancer death [1] . Hepatocellular carcinoma (HCC) is the most common primary malignancy of liver. Men are three times more likely to develop HCC than women and the incidence increases with age [2] . HCC is prevalent in Asia and Africa, but recently it is on the rise in the Western world due to an increase in hepatitis C virus (HCV) infection [3] . Risk factors for HCC include chronic hepatitis B virus (HBV) and HCV infections, cirrhosis, chronic alcohol abuse, aflatoxin ingestion, non-alcoholic steatohepatitis and other metabolic liver diseases [4,5] . Much of HCC occurs in the background of cirrhosis. About 80%-90% of patients with cirrhosis go on to develop HCC eventually and the remaining 10%-20% of cases develop HCC without cirrhosis. Furthermore, HBV and HCV infections increase the risk of developing cirrhosis and later HCC. Among the HCC

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“…The authors considered a high probability of long-term survival of patients with a single lesion ≤4.0 cm in maximum diameter and Child-Pugh class A cirrhosis. Numerous studies have compared MWA with RFA for treating HCC and found similar disease-free survival, cumulative survival, and complication rates in the two groups [68,69,70,71,72,73,74]. However, so far, only one RCT [68] has compared the efficacy of MWA with that of RFA, in a series of 72 patients (36 RFA/36 MWA) with equivalent background demographics and mean tumor sizes.…”

Section: Local Ablative Therapymentioning

confidence: 99%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. Summary: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques. Key Message: Advances in image-guided locoregional therapies, including local ablative therapy and transarterial therapy, have led to a major breakthrough in the management of HCC. Both survival rates and cure rates of patients with HCC have improved markedly since the introduction of these techniques. Practical Implications: Radiofrequency ablation is currently considered as an alternative to surgical resection for patients with early-stage HCC. A newer technique of ablation such as microwave ablation is increasingly being used, especially for large HCC. Transarterial chemoembolization has become a standard care for asymptomatic patients with multinodular tumors in intermediate-stage disease, and transarterial radioembolization has become the method of choice in HCC cases with portal vein thrombosis. Moreover, combination treatment modalities, such as thermal-based ablation combined with transarterial chemoembolization or ¹²⁵I seed implant brachytherapy, may further broaden their clinical indications for HCC. Moreover, use of localized radiation in combination with thermal ablation has been reported to improve tumor control and long-term survival.

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Laparoscopic‐assisted microwave ablation for hepatocellular carcinoma: Safety and efficacy in comparison with radiofrequency ablation

Abstract: Lap-MWA is a safe and efficacious locoregional therapy for HCC which achieves outcomes comparable to Lap-RFA. Shorter operative times were realized with this modality and complete coagulative necrosis was confirmed histologically on explanted livers.

Cited by 84 publications

References 18 publications

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients

Dickkopfs and Wnt/β-catenin signalling in liver cancer

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

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