Faculty Collaboration Database

Recurrence after microwave ablation of liver malignancies: a single institution experience. HPB (Oxford) 2013 May;15(5):365-71

Date

03/06/2013

Pubmed ID

23458599

Pubmed Central ID

PMC3633038

DOI

10.1111/j.1477-2574.2012.00585.x

Scopus ID

2-s2.0-84876050045 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

BACKGROUND: Microwave ablation (MWA) is increasingly used to achieve local control for liver tumours. This study sought to examine a monocentric experience with MWA, with a primary hypothesis that primary tumour histology was a significant predictor of early recurrence.

METHODS: Retrospective single-institution review identified consecutive patients with liver tumours treated by MWA. Cox proportional hazards models assessed significance of prognostic variables.

RESULTS: Seventy-two patients (43 female, 60%) underwent 83 MWA procedures for 157 tumours. Tumour histologies included hepatocellular cancer (10 operations), colorectal metastases (39), metastatic carcinoid (20) and other (14). The median tumour size was 2.0 cm. A concomitant liver resection was performed in 50 cases (60%). Crude peri-operative morbidity and mortality rates were 16% and 1%, respectively. The median follow-up was 16 months. Ablations were complete for 149 out of 157 tumours (95%). The median overall and recurrence-free survivals were 36 and 18 months, respectively. There was no difference in time to recurrence between the primary tumour types. In multivariable models, recurrence-free survival was independently associated with the use of neoadjuvant [hazard ratio (HR): 2.90, 95% confidence interval (CI): 1.09-7.76, P = 0.034] and adjuvant chemotherapy (HR: 0.36, 95% CI: 0.15-0.82, P = 0.016).

CONCLUSIONS: MWA is a safe and feasible approach for local control of liver tumours. While chemotherapy administration was associated with time to recurrence after MWA, larger studies are needed to corroborate these findings.

Author List

Groeschl RT, Wong RK, Quebbeman EJ, Tsai S, Turaga KK, Pappas SG, Christians KK, Hohenwalter EJ, Tutton SM, Rilling WS, Gamblin TC

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin
Eric J. Hohenwalter MD, FSIR Chief, Professor in the Radiology department at Medical College of Wisconsin
William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Ablation Techniques
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Humans
Liver Neoplasms
Male
Microwaves
Middle Aged
Neoplasm Recurrence, Local
Proportional Hazards Models
Retrospective Studies
Survival Rate
Treatment Outcome