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Long-term outcomes following microwave ablation for liver malignancies.

Publication ,  Journal Article
Leung, U; Kuk, D; D'Angelica, MI; Kingham, TP; Allen, PJ; DeMatteo, RP; Jarnagin, WR; Fong, Y
Published in: Br J Surg
January 2015

BACKGROUND: Microwave ablation has emerged as a promising treatment for liver malignancies, but there are scant long-term follow-up data. This study evaluated long-term outcomes, with a comparison of 915-MHz and 2.4-GHz ablation systems. METHODS: This was a retrospective review of patients with malignant liver tumours undergoing operative microwave ablation with or without liver resection between 2008 and 2013. Regional or systemic (neo)adjuvant therapy was given selectively. Local recurrence was analysed using competing-risk methods with clustering, and overall survival was determined from Kaplan-Meier curves. RESULTS: A total of 176 patients with 416 tumours were analysed. Colorectal liver metastases (CRLM) comprised 81.0 per cent of tumours, hepatocellular carcinoma 8.4 per cent, primary biliary cancer 1.7 per cent and non-CRLM 8.9 per cent. Median follow-up was 20.5 months. Local recurrence developed after treatment of 33 tumours (7.9 per cent) in 31 patients (17.6 per cent). Recurrence rates increased with tumour size, and were 1.0, 9.3 and 33 per cent for lesions smaller than 1 cm, 1-3 cm and larger than 3 cm respectively. On univariable analysis, the local recurrence rate was higher after ablation of larger tumours (hazard ratio (HR) 2.05 per cm; P < 0.001), in those with a perivascular (HR 3.71; P = 0.001) or subcapsular (HR 2.71; P = 0.008) location, or biliary or non-CRLM histology (HR 2.47; P = 0.036), and with use of the 2.4-GHz ablation system (HR 3.79; P = 0.001). Tumour size (P < 0.001) and perivascular position (P = 0.045) remained significant independent predictors on multivariable analysis. Regional chemotherapy was associated with decreased local recurrence (HR 0.49; P = 0.049). Overall survival at 4 years was 58.3 per cent for CRLM and 79.4 per cent for other pathology (P = 0.360). CONCLUSION: Microwave ablation of liver malignancies, either combined or not combined with liver resection, and selective regional and systemic therapy resulted in good long-term survival. Local recurrence rates were low after treatment of tumours smaller than 3 cm in diameter, and those remote from vessels.

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Published In

Br J Surg

DOI

EISSN

1365-2168

Publication Date

January 2015

Volume

102

Issue

1

Start / End Page

85 / 91

Location

England

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Middle Aged
  • Microwaves
  • Male
  • Liver Neoplasms
  • Humans
  • Female
 

Citation

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Leung, U., Kuk, D., D’Angelica, M. I., Kingham, T. P., Allen, P. J., DeMatteo, R. P., … Fong, Y. (2015). Long-term outcomes following microwave ablation for liver malignancies. Br J Surg, 102(1), 85–91. https://doi.org/10.1002/bjs.9649
Leung, U., D. Kuk, M. I. D’Angelica, T. P. Kingham, P. J. Allen, R. P. DeMatteo, W. R. Jarnagin, and Y. Fong. “Long-term outcomes following microwave ablation for liver malignancies.Br J Surg 102, no. 1 (January 2015): 85–91. https://doi.org/10.1002/bjs.9649.
Leung U, Kuk D, D’Angelica MI, Kingham TP, Allen PJ, DeMatteo RP, et al. Long-term outcomes following microwave ablation for liver malignancies. Br J Surg. 2015 Jan;102(1):85–91.
Leung, U., et al. “Long-term outcomes following microwave ablation for liver malignancies.Br J Surg, vol. 102, no. 1, Jan. 2015, pp. 85–91. Pubmed, doi:10.1002/bjs.9649.
Leung U, Kuk D, D’Angelica MI, Kingham TP, Allen PJ, DeMatteo RP, Jarnagin WR, Fong Y. Long-term outcomes following microwave ablation for liver malignancies. Br J Surg. 2015 Jan;102(1):85–91.
Journal cover image

Published In

Br J Surg

DOI

EISSN

1365-2168

Publication Date

January 2015

Volume

102

Issue

1

Start / End Page

85 / 91

Location

England

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Middle Aged
  • Microwaves
  • Male
  • Liver Neoplasms
  • Humans
  • Female