Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2022; 14(9): 1727-1738
Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1727
Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma
Ming-Zhi Hao, Yu-Bin Hu, Qi-Zhong Chen, Zhang-Xian Chen, Hai-Lan Lin
Ming-Zhi Hao, Yu-Bin Hu, Qi-Zhong Chen, Zhang-Xian Chen, Hai-Lan Lin, Department of Tumor Interventional Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
Ming-Zhi Hao, Department of Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
Author contributions: Hao MZ, Chen QZ, Hu YB, and Lin HL participated in the microwave ablation operation; Hao MZ participated in the data analysis and interpretation, manuscript writing, and final approval of the manuscript; Chen ZX contributed to the data collection and assembly; Lin HL participated in the conception and design.
Supported by the Fujian Key Laboratory of Translational Cancer Medicine and Fujian Provincial Clinical Research Center for Cancer Radiotherapy and Immunotherapy, China, No. 2020Y2012.
Institutional review board statement: The protocol was approved by the ethics committee of Fujian Provincial Tumor Hospital (approval No. 2018-022-02).
Informed consent statement: Written informed consent was obtained from each patient before study initiation.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Zhi Hao, MM, Professor, Department of Tumor Interventional Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. haomz@fjzlhospital.com
Received: March 14, 2022
Peer-review started: March 14, 2022
First decision: April 11, 2022
Revised: April 18, 2022
Accepted: July 31, 2022
Article in press: July 31, 2022
Published online: September 15, 2022
Processing time: 178 Days and 22.7 Hours
Abstract
BACKGROUND

In microwave ablation (MWA), although computed tomography (CT) scanning can overcome gas interference, it cannot achieve real-time localization. Therefore, the puncture technique is more important in CT-guided ablation.

AIM

To compare the fine needle-assisted puncture (FNP) positioning technique and the conventional puncture (CP) technique for the safety and efficacy of CT-guided MWA in treating hepatocellular carcinoma (HCC).

METHODS

This retrospective study included 124 patients with 166 tumor nodules from February 2018 and June 2021. Seventy patients received CT-guided MWA under the FNP technique (FNP group), and 54 patients received MWA under the CP technique (CP group). Intergroup comparisons were made regarding local tumor progression (LTP), recurrence-free survival (RFS), overall survival (OS), and complications. The influencing variables of LTP and RFS were analyzed through univariate and multivariate regressions.

RESULTS

The 1-, 2-, and 3-year cumulative incidences of LTP in the FNP group were significantly lower than those in the CP group (7.4%, 12.7%, 21.3% vs 13.7%, 32.9%, 36.4%; P = 0.038). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group (80.6%, 73.3%, 64.0% vs 83.3%, 39.4%, and 32.5%, respectively; P = 0.008). The FNP technique independently predicted LTP and RFS. Minor complications in the FNP group were lower than those in the CP group (P < 0.001). The difference in median OS was insignificant between the FNP and CP groups (P = 0.229).

CONCLUSION

The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.

Keywords: Hepatocellular carcinoma; Fine needle puncture; Microwave ablation; Recurrence-free survival; Local tumor progression

Core Tip: This was a retrospective study that compared the fine needle-assisted puncture positioning (FNP) technique and conventional puncture (CP) technique for the safety and efficacy of computed tomography (CT)-guided microwave ablation (MWA) in treating hepatocellular carcinoma (HCC). In total, 124 patients were divided into two groups by the puncture technique. Seventy patients received CT-guided MWA under the FNP technique (FNP group), and 54 patients received MWA under the CP technique (CP group). The FNP technique used in CT-guided MWA may improve outcomes in terms of local tumor progression, recurrence-free survival, and procedure-related complications for HCC.