RESUMO
PURPOSE: To compare the therapeutic response and clinical outcome of CT-guided percutaneous microwave (MWA) and radiofrequency ablation (RFA) for the treatment of small- and medium-sized HCC. MATERIALS AND METHODS: In this prospective trial, 50 patients with HCC were randomly assigned to MWA or RFA treatment. MRI was performed 24âh before and after ablation and subsequently in 3-month intervals. Ablation volumes, ablation durations, adverse events (AE), technique efficacy, technical success, local tumor progression (LTP), disease-free survival (DFS), intrahepatic distant recurrence (IDR), and overall survival (OS) rates were evaluated. RESULTS: The mean ablation volume was 66.5âcm³ for MWA and 29.2 âcm³ for RFA (pâ<â0.01). The mean ablation durations for MWA and RFA were 11.2â±â4.0âmin and 16.3â±â4.7âmin, respectively (pâ<â0.01). Six mild AEs were documented (pâ>â0.05). All treatments had a technical success rate and a technique efficacy rate of 100â% (50/50, pâ=â1.00). LTP within 2 years occurred in 1/25 (4â%) in the MWA group and in 4/25 (16â%) in the RFA group (pâ=â0.06). IDR within 2 years was 8/25 (32â%) for MWA and 14/25 (56â%) for RFA (pâ<â0.05). The median DFS was 24.5 months and 13.4 months for MWA and RFA, respectively (pâ=â0.02). The 1-, 2-, 3-year OS rates were 100â%, 80â%, 72â% in the MWA group and 72â%, 64â%, 60â% in the RFA group, respectively (pâ≥â0.14). CONCLUSION: The clinical outcome after MWA or RFA for HCC treatment was very similar with no significant differences in LTP or OS.âHowever, MWA shows a trend toward better DFS with fewer IDRs than RFA. KEY POINTS: · MWA allows for larger ablation volumes and a shorter treatment duration compared to RFA in patients with HCC.. · MWA shows a trend toward better disease-free survival and fewer intrahepatic distant recurrences compared to RFA.. · The three-year survival rates show no significant difference between the two methods..
