Videolaparoscopic microwave ablation in patients with HCC at a European high-volume center: Results of 815 procedures

Umberto Cillo, Alessandra Bertacco, Elisa Fasolo, Riccardo Carandina, Alessandro Vitale, Giacomo Zanus, Enrico Gringeri, Francesco D'Amico, Domenico Bassi, Daniele Neri, Vincenzo Dadduzio, Fabio Farinati, Camillo Aliberti

Research output: Contribution to journalArticle

Abstract

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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%.

CONCLUSIONS: 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.

Original languageEnglish
Pages (from-to)956-965
Number of pages10
JournalJournal of Surgical Oncology
Volume120
Issue number6
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular/pathology
  • Catheter Ablation/mortality
  • Europe
  • Female
  • Follow-Up Studies
  • Hospitals, High-Volume/statistics & numerical data
  • Humans
  • Laparoscopy/mortality
  • Liver Neoplasms/pathology
  • Longitudinal Studies
  • Male
  • Microwaves/therapeutic use
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Survival Rate
  • Video-Assisted Surgery/mortality

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  • Cite this

    Cillo, U., Bertacco, A., Fasolo, E., Carandina, R., Vitale, A., Zanus, G., Gringeri, E., D'Amico, F., Bassi, D., Neri, D., Dadduzio, V., Farinati, F., & Aliberti, C. (2019). Videolaparoscopic microwave ablation in patients with HCC at a European high-volume center: Results of 815 procedures. Journal of Surgical Oncology, 120(6), 956-965. https://doi.org/10.1002/jso.25651