Clinical study on ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma.

Abstract

Objectives: To evaluate the efficacy, safety, and survival benefits of ultrasound-guided microwave ablation (MWA) compared to surgical resection (SR) in patients with hepatocellular carcinoma (HCC).

Methods: This retrospective study included 100 patients with HCC who underwent either ultrasound-guided MWA (n = 58) or SR (n = 42). Baseline characteristics, liver function tests, tumor markers, complications, and survival outcomes were analyzed. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors criteria, with follow-up evaluations at 12, 24, and 36 months.

Results: MWA demonstrated superior clinical outcomes compared to SR (P < 0.001). Post-treatment levels of liver enzymes (alanine aminotransferase, aspartate aminotransferase) and total bilirubin. Both groups showed significant reductions in alpha-fetoprotein and carbohydrate antigen 19-9 levels, with no significant difference between them (both P < 0.001). The complication rate was significantly lower in the MWA group (P < 0.001). Tumor response, including complete response (CR) and overall response rate (ORR), was higher in the MWA group (CR: 40 vs. 20; ORR: 86.2% vs. 65.6%). Additionally, progression-free survival (PFS) and overall survival (OS) at 12, 24, and 36 months were significantly better in the MWA group (all P < 0.001).

Conclusion: Ultrasound-guided MWA provides notable advantages over SR in the treatment of HCC, including less hepatic injury, fewer complications, and improved PFS and OS. These findings support MWA as a safe, minimally invasive, and effective alternative for HCC management.