Pulsed microwave ablation reduces complications in hepatocellular carcinoma located in high-risk areas: a retrospective comparative study.

BACKGROUND

Ultrasound-guided microwave ablation (MWA) is widely used for small hepatocellular carcinoma (HCC), but treating tumors in high-risk sites requires minimizing damage to surrounding tissues. This study introduced a pulsed microwave ablation (PMA) technique and compared it with continuous microwave ablation (C-MWA) to assess its efficacy and safety in managing HCC in high risk locations.

METHODS

A retrospective analysis was conducted on patients with HCC in high-risk locations treated at our institution between November 2019 and November 2022. Patients treated before January 2021 (n = 24 lesions) underwent C-MWA (control group), while those treated after January 2021 (n = 19 lesions) received PMA (study group). Baseline characteristics, laboratory tests, imaging, and follow-up data were analyzed.

RESULTS

Baseline data were comparable between groups. Postoperative increases in ALT, AST, and total bilirubin were significantly lower in the study group. The incidence of adverse events was 36.8% in the study group and 70.8% in the control group (p = 0.026). Surgical approach (p = 0.028, OR = 8.571) and tumor diameter (p = 0.003, OR = 26.703) were independent risk factors for adverse events. During two-year follow-up, five recurrences occurred in the control group and none in the study group (LogRank p = 0.037). Tumor diameter (p = 0.047, OR = 77.28) and history of cirrhosis (p = 0.041, OR = 0.008) were independent predictors of recurrence.

CONCLUSIONS

PMA reduced complications compared to C-MWA, showing potential as a safer and effective option for HCC in high-risk locations. Further validation in larger studies is warranted.