Department of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplant Unit, Padua University, Padua, Italy.
Department of Radiology, AOP-Padua University, Padua, Italy.
J Surg Oncol. 2019 Nov;120(6):956-965. doi: 10.1002/jso.25651. Epub 2019 Aug 1.
Videolaparoscopic (VL) microwave ablation (MWA) is not included in most of the international guidelines as a therapeutic option for hepatocellular carcinoma (HCC). Aim of this study was to assess the safety of VL MWA in patients with HCC for whom resection or percutaneous ablation is unsuitable.
A retrospective analysis was performed on a prospective database of patients with HCC treated with VL MWA at our institution from 2009 to 2016. Patient demographics, operational characteristics, and complications were recorded. Statistical analysis was performed to identify safety profile, overall survival and recurrence rate.
A total of 815 VL MWA were performed in 674 patients with a mean age of 64 years. Patients had a mean Model for End-stage Liver Disease score of 10 (±3); 32.8% were Child B, 44.1% Barcelona Clinic Liver Cancer B-C. Perioperative mortality was 0.4%. Overall morbidity was 30.8%, with Dindo-Clavien complications ≥3 in 2%. The median length of stay was 2 days. In 43.1% VL MWA was the first-line therapy. Overall 1-, 3-, and 5-year survival rates were 81.9%, 54.9%, and 35.9%.
The present is the largest series of VL ablation and the bigger number of patients with HCC treated with MW reported nowadays. It confirms the safety of a minimally invasive procedure for patients with HCC when resection or percutaneous ablation is not feasible.
视频腹腔镜（VL）微波消融（MWA）不作为大多数国际指南中肝细胞癌（HCC）的治疗选择。本研究旨在评估 VL MWA 治疗不适合手术或经皮消融的 HCC 患者的安全性。
对 2009 年至 2016 年在我院接受 VL MWA 治疗的 HCC 患者的前瞻性数据库进行回顾性分析。记录患者的人口统计学、手术特征和并发症。进行统计分析以确定安全性、总生存率和复发率。
共对 674 例 HCC 患者进行了 815 次 VL MWA，平均年龄为 64 岁。患者平均终末期肝病模型评分 10（±3）；32.8%为 Child B，44.1%为巴塞罗那临床肝癌 B-C。围手术期死亡率为 0.4%。总发病率为 30.8%，Dindo-Clavien 并发症≥3 级者占 2%。中位住院时间为 2 天。在 43.1%的 VL MWA 中，该手术为一线治疗。总体 1、3 和 5 年生存率分别为 81.9%、54.9%和 35.9%。
目前是最大系列的 VL 消融和报道的最大数量的 HCC 患者接受 MW 治疗。它证实了对于不适合手术或经皮消融的 HCC 患者，微创治疗是安全的。
