ABSTRACT
Objective To analyze the safety and efficacy of ultrasound-guided microwave ablation (MWA) for patients with primary hepatocellular carcinoma (HCC) at dangerous locations.Methods Data of 375 patients with HCC underwent MWA were retrospectively analyzed.According to the location of tumors,the patients were classified into dangerous group (distance from vital tissues to lesions ≤5 mm) and non-dangerous group (distance from vital tissues to lesions ＞5 mm).The efficacy of MWA and the incidence of serious complications of the two groups were compared.Results There were 196 patients with 258 lesions in dangerous group and 179 patients with 233 lesions in non-dangerous group.No statistical differences of the completed ablation rate was found between dangerous group (97.67％ [252/258]) and non-dangerous group (97.85％ [228/233],P=0.61).The 1-,3-,5-year local tumor progression (LTP) rates were 9.57％,19.72％,24.18％ in dangerous group and 7.34％,13.44％,14.61％ in non-dangerous group.The 1-,3-,5-year progression free survival (PFS) rates were 68.88％,36.22％,25.37％ in dangerous group and 73.74％,43.17％,19.12％ in non-dangerous group.The 1-,3-,5-year overall survival (OS) rates in dangerous group and non-dangerous group were 90.87％,69.50％,60.05％ and 94.97％,74.24％,64.91％,respectively.No statistically significant differences of the 1-,3-,5-year LTP,OS and PFS rates were found between the two groups (P=0.11,0.19,0.17).The serious complications rates were 3.06 ％ (9/196) and 1.11 ％ (2/179) in dangerous group and non-dangerous group,respectively,which had no statistically significant difference between the two groups (P =0.35).Conclusion Ultrasound-guided percutaneous MWA is safe and effective for patients with HCC at dangerous locations.The adjuvant methods can help MWA to gain the similar local and long-term outcomes for patients with HCC at dangerous locations to those at non-dangerous locations.