J Liver Cancer.  2025 Mar;25(1):99-108. 10.17998/jlc.2025.02.02.

Microwave ablation vs. liver resection for patients with hepatocellular carcinomas

• Gu H
• Seo Y
• Chung DJ
• Paik KY
• Yoon SK
• Lim J

• KMID: 2567068
• DOI: http://doi.org/10.17998/jlc.2025.02.02

Abstract

Backgrounds/Aims
Microwave ablation (MWA) is an emerging ablative therapy that surpasses previous methods by achieving higher temperatures and creating larger ablation zones within shorter periods. This study compared the therapeutic outcomes of MWA with those of liver resection in real-world clinical practice.
Methods
A total of 178 patients with 259 nodules who underwent MWA or liver resection between January 2015 and July 2023 were enrolled. Local tumor progression (LTP)-free survival, overall progression (OP)-free survival, and overall survival (OS) were assessed based on the treatment modality for the index nodule.
Results
Of the 178 patients, 134 with 214 nodules underwent MWA, and 44 with 45 nodules underwent liver resection. The median follow-up period was 2.0±1.5 years. The annual incidence of LTP was 3.7% for MWA and 1.4% for liver resection. Treatment modality did not significantly affect LTP-free survival (hazard ratio, 0.61; 95% confidence interval, 0.14-2.69; P=0.511). For nodules larger than 3 cm, LTP-free survival was not affected by the treatment modality. Similarly, OP-free survival and OS were not influenced by treatment modality.
Conclusions
MWA and liver resection demonstrated comparable treatment outcomes in terms of local tumor control, overall recurrence, and survival. MWA may be an alternative treatment option for select patients; however, further studies are necessary to generalize these findings.

Keyword

Carcinoma, hepatocellular; Ablation techniques; Microwaves; Surgical procedures; operative

Figure

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  Figure 1. Kaplan-Meier analyses for LTP-free survival of MWA and liver resection-treated (A) entire 259 target nodules and (B) 80 target nodules ≥3 cm. LTP, local tumor progression; MWA, microwave ablation.

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  Figure 2. Kaplan-Meier analyses for (A) OP-free survival and (B) overall survival of 178 patients treated with MWA and liver resection. MWA, microwave ablation.

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Reference

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