Microwave ablation shows similar survival outcomes compared with surgical resection for hepatocellular carcinoma between 3 and 5 cm

Microwave ablation (MWA) is a safe and effective locoregional ablation modality, but it is not clear whether the curative effect of MWA as to hepatocellular carcinoma (HCC) is comparable to that of surgical resection (SR). We aimed to compare the outcomes of MWA and SR for patients with HCC ranging from 3 to 5 cm. 197 patients treated for HCC between 3 and 5 cm by MWA or SR were included from 2010 to 2017. Overall survival (OS), progression-free survival (PFS), complication and hospital stay of those patients were compared by using propensity score matching. The registration number of this clinical trial was ChiCTR2000033983. For patients with HCC between 3 and 5 cm, the 1-, 3-, and 5- years OS rates were 90.3%, 79.7%, and 65.5% in the MWA group, and 96.7%, 88.6%, and 71%% in the SR group, respectively (<i>p</i> = 0.457). The 1-, 3- and 5- years PFS rates were 63.6%, 36.8% and 32.7% in the MWA group, and 74.2%, 41.9% and 35.5% in the SR group, respectively (<i>p</i> = 0.397). The MWA group showed fewer complications (55% versus 78.8%, <i>p</i> = 0.041) and shorter hospital stays (8 versus 15 days, <i>p</i> &lt; 0.001) compared with the SR group. MWA showed similar survival outcomes compared with SR for HCCs ranging from 3 to 5 cm. However, it showed favorable results in terms of hospital stay and complication rate compared to SR.

微波消融（Microwave Ablation, MWA）是一种安全有效的局部消融治疗手段，但目前尚不明确其针对肝细胞癌（Hepatocellular Carcinoma, HCC）的治疗效果是否可与手术切除（Surgical Resection, SR）相媲美。本研究旨在对比直径3~5 cm的肝细胞癌患者分别接受MWA与SR的治疗结局。本研究纳入2010至2017年间共197例接受MWA或SR治疗的直径3~5 cm HCC患者，采用倾向得分匹配法对比两组患者的总生存期（Overall Survival, OS）、无进展生存期（Progression-Free Survival, PFS）、并发症发生情况及住院时长。本临床试验的注册编号为ChiCTR2000033983。对于直径3~5 cm的HCC患者，MWA组的1年、3年、5年OS率分别为90.3%、79.7%及65.5%，SR组则分别为96.7%、88.6%及71.5%（<i>p</i> = 0.457）。MWA组的1年、3年及5年PFS率分别为63.6%、36.8%与32.7%，SR组则分别为74.2%、41.9%与35.5%（<i>p</i> = 0.397）。与SR组相比，MWA组并发症发生率更低（55% vs 78.8%，<i>p</i> = 0.041），且住院时长更短（8天 vs 15天，<i>p</i> < 0.001）。针对直径3~5 cm的HCC患者，MWA与SR的生存结局无显著差异；但在住院时长及并发症发生率方面，MWA组表现更优。