Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 101786
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.101786
Efficacy of microwave ablation vs laparoscopic hepatectomy for primary small liver cancer: A comparative study
Huan-Song Li, Xuan-Feng Zhang, Jun Fu, Bo Yuan
Huan-Song Li, Xuan-Feng Zhang, Jun Fu, Bo Yuan, Department of Hepatobiliary Pancreatic Center, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China
Co-first authors: Huan-Song Li and Xuan-Feng Zhang.
Co-corresponding authors: Jun Fu and Bo Yuan.
Author contributions: Li HS and Zhang XF designed the research and wrote the first manuscript; Li HS, Zhang XF, Fu J and Yuan B contributed to conceiving the research and analyzing data, conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript. Li HS and Zhang XF contributed equally to this work as co-first authors. Both Fu J and Yuan B have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Yuan B conceptualized, designed, and supervised the whole process of the project. Fu J searched the literature, revised and submitted the early version of the manuscript. Fu J and Yuan B was instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Fu J and Yuan B is crucial for the publication of this manuscript and other manuscripts still in preparation.
Institutional review board statement: This study was approved by the Ethic Committee of Xuzhou Central Hospital.
Informed consent statement: The requirement for written informed consent was waived due to retrospective design of the study.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The statistical data used in this study can be obtained from the corresponding author upon request.
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: Bo Yuan, Associate Chief Physician, Department of Hepatobiliary Pancreatic Center, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou 221009, Jiangsu Province, China. shimingyb666@sina.com
Received: November 7, 2024
Revised: December 13, 2024
Accepted: January 7, 2025
Published online: March 27, 2025
Processing time: 108 Days and 19.4 Hours
Abstract
BACKGROUND

In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation (MWA) and laparoscopic hepatectomy (LH), which are both important treatment modalities for liver neoplasms, have been limited in patients diagnosed with primary small liver cancer (PSLC).

AIM

To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.

METHODS

This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups. The LH group, consisting of 61 cases, received LH, and the MWA group, which included 62 cases, underwent liver tumor MWA. Basic data and various perioperative indicators were compared between the two groups, including changes in liver function indicators [alanine aminotransferase (ALT), glutamic aminotransferase (AST), and total bilirubin (TBIL)] pre- and post-treatment, and efficacy and postoperative complications were analyzed.

RESULTS

No statistically significant difference was observed between the two groups in terms of age, gender, tumor diameter, liver function Child-Pugh classification and number of tumors, body mass index, and educational status (P > 0.05). The overall effective rate was higher in the MWA group than in the LH group (98.39% vs 88.52%) (χ2 = 4.918, P = 0.027). The MWA group exhibited less operation time, intraoperative bleeding, defecation time, and hospital stay than the LH group (P < 0.05). No difference was found in liver function indicators between the two groups pre-treatment (P > 0.05), and ALT, AST, and TBIL levels decreased in both groups post-treatment, with the MWA group demonstrating lower levels (P < 0.05). The MWA and LH groups exhibited postoperative complication rates of 4.84% and 19.67%, respectively, with statistically significant differences between the two groups (P = 0.012, χ2 = 6.318).

CONCLUSION

MWA is more effective in treating PSLC, and it promotes faster postoperative recovery for patients, and more security improves liver function and reduces postoperative complications compared to LH.

Keywords: Microwave ablation of liver tumors; Laparoscopic hepatectomy; Primary small liver cancer; Clinical outcome

Core Tip: This study primarily aimed to comparatively analyze the clinical effectiveness of liver tumor microwave ablation (MWA) and laparoscopic hepatectomy (LH) in treating primary small liver cancer (PSLC). We conducted a comparative analysis of the two intervention methods from multiple perspectives, including various perioperative indicators, changes in liver function indicators pre- and post-treatment, curative effects, and postoperative complications. This study confirmed that MWA demonstrated better curative effects than LH in PSLC treatment, with a reduced intraoperative blood loss level, shorter surgical procedure and hospitalization durations, rapid recovery facilitation, liver function improvement, postoperative complication reduction, and a high safety level. Therefore, selecting the appropriate surgical method is the key to achieving better clinical outcomes. Our analysis provides more reliable clinical references and options for future PSLC treatment.