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Article

Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success

by
Antonia-Maria Pausch
1,2,
Tamam Ghali
1,
Tobias Wertheimer
3,
Florian Zeman
4,
Karolina Mueller
4,
Michael Christian Doppler
5,
Ingo Einspieler
1,
Lukas Philipp Beyer
6,
Stephan Schleder
7,
Christian Stroszczynski
1 and
Lukas Luerken
1,*
1
Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany
2
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland
3
Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053 Regenburg, Germany
4
Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany
5
Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
6
Department of Diagnostic and Interventional Radiology, Klinikum Ernst von Bergmann, 14467 Potsdam, Germany
7
Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
*
Author to whom correspondence should be addressed.
Tomography 2023, 9(1), 50-59; https://doi.org/10.3390/tomography9010005
Submission received: 19 November 2022 / Revised: 19 December 2022 / Accepted: 23 December 2022 / Published: 26 December 2022
(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)
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Abstract

Background: Microwave ablation (MWA) has gained relevance in the treatment of hepatic malignancies and especially in hepatocellular carcinoma (HCC), and it is an important alternative to surgery. The purpose of the study was to evaluate whether the minimal ablative margin (MAM) or the initial tumor size has a greater effect on the success of stereotactic MWA of HCC regarding the time to local tumor progression (LTP) and overall survival (OS). Methods: 88 patients, who received stereotactic MWA of 127 tumor lesions with a curative intention were included in this single-center, retrospective study. The MAM was evaluated in a side-by-side comparison of pre- and post-ablative, contrast-enhanced slice imaging. A Cox proportional hazard model with a frailty term was computed to assess the influence of the MAM and the maximum tumor diameter on the time to LTP and the OS. Results: The maximum tumor diameter was identified as a significant positive predictor for LTP (hazard ratio 1.04, 95% CI 1.00–1.08, p = 0.03), but it was not a significant positive predictor for the OS (p = 0.20). The MAM did not have a significant influence on LTP-free survival (p = 0.23) and OS (p = 0.67). Conclusion: For the successful stereotactic MWA of HCC, the MAM and maximum tumor diameter might not have an influence on the OS, but the maximum tumor diameter seems to be an independent predictor of the time to LTP.
Keywords: interventional oncology; stereotactic navigation; microwave ablation; hepatocellular carcinoma interventional oncology; stereotactic navigation; microwave ablation; hepatocellular carcinoma

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MDPI and ACS Style

Pausch, A.-M.; Ghali, T.; Wertheimer, T.; Zeman, F.; Mueller, K.; Doppler, M.C.; Einspieler, I.; Beyer, L.P.; Schleder, S.; Stroszczynski, C.; et al. Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success. Tomography 2023, 9, 50-59. https://doi.org/10.3390/tomography9010005

AMA Style

Pausch A-M, Ghali T, Wertheimer T, Zeman F, Mueller K, Doppler MC, Einspieler I, Beyer LP, Schleder S, Stroszczynski C, et al. Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success. Tomography. 2023; 9(1):50-59. https://doi.org/10.3390/tomography9010005

Chicago/Turabian Style

Pausch, Antonia-Maria, Tamam Ghali, Tobias Wertheimer, Florian Zeman, Karolina Mueller, Michael Christian Doppler, Ingo Einspieler, Lukas Philipp Beyer, Stephan Schleder, Christian Stroszczynski, and et al. 2023. "Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success" Tomography 9, no. 1: 50-59. https://doi.org/10.3390/tomography9010005

APA Style

Pausch, A.-M., Ghali, T., Wertheimer, T., Zeman, F., Mueller, K., Doppler, M. C., Einspieler, I., Beyer, L. P., Schleder, S., Stroszczynski, C., & Luerken, L. (2023). Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success. Tomography, 9(1), 50-59. https://doi.org/10.3390/tomography9010005

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