Thomas Josef Vogl MD, PhD, Presenter: Nothing to Disclose

Stefan Zangos MD, Abstract Co-Author: Nothing to Disclose

Jorg Trojan MD, Abstract Co-Author: Nothing to Disclose

Nagy Naguib Naeem Naguib MD, MSc, Abstract Co-Author: Nothing to Disclose

Nour-Eldin Abdelrehim Nour-Eldin MD, MSc, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate and compare the therapeutic response of radiofrequency ablation (RFA) and microwave ablation (MWA) therapy of hepatocellular carcinoma (HCC).

Institutional review board approval was obtained prior to this prospective study and written informed consent was obtained from all patients included in the study for both the ablation procedure and anonymous use of their data for research purposes. From September 2008 to December 2011, 53 consecutive patients (42 males/11 females; mean, 59 years; range 40–68; SD, 4.2) underwent CT-guided percutaneous RFA and MWA of 68 HCC lesions. The inclusion and exclusion criteria were in accordance with the Barcelona Clinic Liver Cancer (BCLC) criteria for indications and contraindications for ablation therapy of HCC. The morphologic tumor response (number, location and size) was evaluated by MRI. Follow-up protocol was 24 hours post ablation, then in 3-month intervals post ablation in the first year and in 6-month intervals thereafter.

Complete therapeutic response was documented in 84.4% (27/32) of lesions treated with RFA and in 88.9% (32/36) of lesions treated with MWA (p=0.6). Complete response was achieved in all lesions ≤2.0 cm in diameter in both groups. There was no significant difference in rates of residual foci of HCC lesions between RFA and MWA groups (p=0.15, Log-rank test). Recurrence rate for 3, 6, and 9 months in patients with HCC who underwent RFA vs. MWA were 6.3%, 3.1%, 3.1% vs. 0%, 5.6%, 2.8%. Time-to-progression in patients treated with RFA compared with MWA was 6.6 vs. 8.3 months. Progression-free-survival rate for patients treated with RFA was 96.9%, 93.8% and 90.6% at 1, 2, and 3 years, for patients treated with MWA it was 97.2%, 94.5%, and 91.7%, respectively (p=0.98).  

In conclusion, RFA and MWA therapy showed no significant difference in the treatment of HCC regarding complete response, rates of residual foci of untreated disease and recurrence rate.

RFA or MWA can be used with similar results concerning local tumor control of HCC

Vogl, T, Zangos, S, Trojan, J, Naguib, N, Nour-Eldin, N, Thermal Ablation in the Treatment of Hepatocellular Carcinoma (HCC): Radiofrequency Ablation (RFA) vs. Microwave Ablation (MWA).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005938.html