Microwave ablation for hepatic malignancies: a systematic review of the technology and differences in devices.
Humans
Male
Child, Preschool
Child
Adolescent
Young Adult
Adult
Middle Aged
Aged
Aged, 80 and over
Female
Microwaves
/ therapeutic use
Liver Neoplasms
/ surgery
Carcinoma, Hepatocellular
/ surgery
Radiofrequency Ablation
Technology
Catheter Ablation
/ adverse effects
Treatment Outcome
Retrospective Studies
Cholangiocarcinoma
Colorectal liver metastasis
Hepatocellular carcinoma
Liver
Microwave ablation
Oncology
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
16
02
2022
accepted:
15
08
2022
pubmed:
9
9
2022
medline:
25
2
2023
entrez:
8
9
2022
Statut:
ppublish
Résumé
Microwave ablation (MWA) has become the standard thermal-based treatment for hepatic malignancies in patients who have unresectable disease based on the biology of the tumor, the patients' comorbidities, and certain disease sites. The technical effectiveness, ablation success, local recurrence rates of hepatic malignancies treated with the various commercial microwave ablation devices has not been previously published in the peer reviewed literature. The aim of this systematic review is to summarize the clinical outcomes for the various MWA devices in the use of a hepatic malignancies to best educate hepatic surgeons as well as interventional radiologists. A comprehensive review of the literature and instructions for use of each device that was published from 1/2013 to 12/2020 was performed. The main outcomes extracted were technical success, ablation success, major complications, local and new recurrence rates, recurrence-free survival, ablation volumes, time, and the number of antennas required. A qualitative review of the literature was performed. In total, 29 studies reporting data on 3250 patients and 4500 tumors were included in this review. Median patient age was 60.5 years (range 3-91). 76.3% (2420 M/753 F) of patients were male. Hepatocellular carcinoma (55%) was the most common tumor pathology followed by colorectal liver metastasis (10%) and cholangiocarcinoma (4%). A majority of studies reported technical success (range, 91.6-100%) and ablation success (range, 73.1-100%), as well as major complications (range, 0-9.1%). Local recurrence (range, 0-50%) was reported by 21 of the studies; however, new recurrence (range, 12.2-64%) was reported less frequently (6 studies) and were further specified in 12, six, and four studies as intrahepatic distant recurrence (11.3-54.2%), extrahepatic distant recurrence (3.6-20%), and metastasis (1.1-36%). A total of three, six, and five studies report disease, progression, and recurrence-free survival rates, respectively. Microwave ablation is frequently used for the treatment of hepatic malignancies. A thorough understanding of the clinical outcomes associated with different pathologies and MWA devices can improve surgeon awareness and help prepare for operative planning and patient management. More consistent reporting of key outcomes in the literature is needed to achieve such an understanding.
Sections du résumé
BACKGROUND
Microwave ablation (MWA) has become the standard thermal-based treatment for hepatic malignancies in patients who have unresectable disease based on the biology of the tumor, the patients' comorbidities, and certain disease sites. The technical effectiveness, ablation success, local recurrence rates of hepatic malignancies treated with the various commercial microwave ablation devices has not been previously published in the peer reviewed literature. The aim of this systematic review is to summarize the clinical outcomes for the various MWA devices in the use of a hepatic malignancies to best educate hepatic surgeons as well as interventional radiologists.
METHODS
A comprehensive review of the literature and instructions for use of each device that was published from 1/2013 to 12/2020 was performed. The main outcomes extracted were technical success, ablation success, major complications, local and new recurrence rates, recurrence-free survival, ablation volumes, time, and the number of antennas required. A qualitative review of the literature was performed.
RESULTS
In total, 29 studies reporting data on 3250 patients and 4500 tumors were included in this review. Median patient age was 60.5 years (range 3-91). 76.3% (2420 M/753 F) of patients were male. Hepatocellular carcinoma (55%) was the most common tumor pathology followed by colorectal liver metastasis (10%) and cholangiocarcinoma (4%). A majority of studies reported technical success (range, 91.6-100%) and ablation success (range, 73.1-100%), as well as major complications (range, 0-9.1%). Local recurrence (range, 0-50%) was reported by 21 of the studies; however, new recurrence (range, 12.2-64%) was reported less frequently (6 studies) and were further specified in 12, six, and four studies as intrahepatic distant recurrence (11.3-54.2%), extrahepatic distant recurrence (3.6-20%), and metastasis (1.1-36%). A total of three, six, and five studies report disease, progression, and recurrence-free survival rates, respectively.
CONCLUSION
Microwave ablation is frequently used for the treatment of hepatic malignancies. A thorough understanding of the clinical outcomes associated with different pathologies and MWA devices can improve surgeon awareness and help prepare for operative planning and patient management. More consistent reporting of key outcomes in the literature is needed to achieve such an understanding.
Identifiants
pubmed: 36076101
doi: 10.1007/s00464-022-09567-2
pii: 10.1007/s00464-022-09567-2
doi:
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
817-834Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Izzo F, Granata V, Grassi R, Fusco R, Palaia R, Delrio P et al (2019) Radiofrequency ablation and microwave ablation in liver tumors: an update. Oncologist 24(10):e990–e1005
doi: 10.1634/theoncologist.2018-0337
pubmed: 31217342
pmcid: 6795153
Lubner MG, Brace CL, Ziemlewicz TJ, Hinshaw JL, Lee FT Jr (2013) Microwave ablation of hepatic malignancy. Semin Intervent Radiol 30(1):56–66
doi: 10.1055/s-0033-1333654
pubmed: 24436518
pmcid: 3700788
Simon CJ, Dupuy DE, Mayo-Smith WW (2005) Microwave ablation: principles and applications. Radiographics 25(Suppl 1):S69-83
doi: 10.1148/rg.25si055501
pubmed: 16227498
Brace CL (2009) Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences? Curr Probl Diagn Radiol 38(3):135–143
doi: 10.1067/j.cpradiol.2007.10.001
pubmed: 19298912
pmcid: 2941203
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1-34
doi: 10.1016/j.jclinepi.2009.06.006
pubmed: 19631507
Agency for healthcare research and quality. National guideline C. practicing chiropractors’ Committee on radiology protocols (PCCRP) for biomechanical assessment of spinal subluxation in chiropractic clinical practice Available from: https://www.ahrq.gov/gam/index.html .
Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13
doi: 10.1186/1471-2288-5-13
pubmed: 15840177
pmcid: 1097734
An C, Cheng ZG, Yu XL, Han ZY, Liu FY, Li X et al (2020) Ultrasound-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: oncologic outcomes and advanced assistive technology. Int J Hyperth 37(1):89–100
doi: 10.1080/02656736.2019.1711203
An C, Hu ZL, Liang P, Cheng ZG, Han ZY, Yu J et al (2018) Ultrasound-guided percutaneous microwave ablation vs. surgical resection for thoracoabdominal wall implants from hepatocellular carcinoma: intermediate-term results. Int J Hyperthermia 34(7):1067–1076
doi: 10.1080/02656736.2017.1402131
pubmed: 29161924
An C, Li X, Yu XL, Cheng ZG, Han ZY, Liu FY et al (2019) Nomogram based on albumin-bilirubin grade to predict outcome of the patients with hepatitis C virus-related hepatocellular carcinoma after microwave ablation. Cancer Biol Med 16(4):797–810
doi: 10.20892/j.issn.2095-3941.2018.0486
pubmed: 31908896
pmcid: 6936230
Arndt L, Villalobos A, Wagstaff W, Cheng B, Xing M, Ermentrout RM et al (2020) Evaluation of medium-term efficacy of Y90 radiation segmentectomy vs percutaneous microwave ablation in patients with solitary surgically unresectable < 4 cm Hepatocellular carcinoma: a propensity score matched study. Cardiovasc Intervent Radiol 44(3):401–413. https://doi.org/10.1007/s00270-020-02712-1
doi: 10.1007/s00270-020-02712-1
pubmed: 33230652
Biondetti P, Fumarola EM, Ierardi AM, Coppola A, Gorga G, Maggi L et al (2020) Percutaneous US-guided MWA of small liver HCC: predictors of outcome and risk factors for complications from a single center experience. Med Oncol 37(5):39
doi: 10.1007/s12032-020-01365-x
pubmed: 32239295
Cathomas M, Mertineit N, Kim-Fuchs C, Lachenmayer A, Maurer MH (2020) Value of MRI/CT image fusion for targeting “invisible” lesions in stereotactic microwave ablation (SMWA) of malignant liver lesions: a retrospective analysis. Cardiovasc Intervent Radiol 43(10):1505–1514
doi: 10.1007/s00270-020-02565-8
pubmed: 32642989
Cui R, Yu J, Gu Y, Cao F, Liu FY, Dong LN et al (2019) Microwave ablation assisted by three-dimensional visualization system as local therapy for relapsed hepatoblastoma: a small pilot study. Abdom Radiol (NY) 44(8):2909–2915
doi: 10.1007/s00261-019-02011-5
pubmed: 31089779
Ding JM, Zhou Y, Wang YD, Jing X, Wang FM, Wang YJ (2017) Percutaneous microwave ablation of exophytic tumours in hepatocellular carcinoma patients: safe or not? Liver Int 37(9):1365–1372
doi: 10.1111/liv.13426
pubmed: 28319345
Giorgio A, Gatti P, Montesarchio L, Merola MG, Amendola F, Calvanese A et al (2018) Microwave ablation in intermediate hepatocellular carcinoma in cirrhosis: an italian multicenter prospective study. J Clin Transl Hepatol 6(3):251–257
pubmed: 30271736
pmcid: 6160301
Li W, Zhou X, Huang Z, Zhang K, Luo X, Zhong J et al (2017) Short-term and long-term outcomes of laparoscopic hepatectomy, microwave ablation, and open hepatectomy for small hepatocellular carcinoma: a 5-year experience in a single center. Hepatol Res 47(7):650–657
doi: 10.1111/hepr.12785
pubmed: 27487979
Medhat E, Abdel Aziz A, Nabeel M, Elbaz T, Zakaria Z, Shousha H et al (2015) Value of microwave ablation in treatment of large lesions of hepatocellular carcinoma. J Dig Dis 16(8):456–463
doi: 10.1111/1751-2980.12259
pubmed: 25958973
Mogahed MM, Zytoon AA, Eysa B, Manaa M, Abdellatif W (2021) Outcome of laparoscopic assisted percutaneous microwave ablation for exophytic versus non-exophytic hepatocellular carcinoma. J Gastrointest Cancer 52(3):892–898
doi: 10.1007/s12029-020-00477-x
pubmed: 32869147
Puijk RS, Plantes VZD, Nieuwenhuizen S, Ruarus AH, Vroomen L, de Jong MC et al (2019) Propofol compared to midazolam sedation and to general anesthesia for percutaneous microwave ablation in patients with hepatic malignancies: a single-center comparative analysis of three historical cohorts. Cardiovasc Intervent Radiol 42(11):1597–1608
doi: 10.1007/s00270-019-02273-y
pubmed: 31243542
pmcid: 6775535
Schaible J, Pregler B, Verloh N, Einspieler I, Baumler W, Zeman F et al (2020) Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system. Radiol Oncol 54(3):295–300
doi: 10.2478/raon-2020-0033
pubmed: 32463387
pmcid: 7409605
Shen XZ, Ma SC, Tang XY, Wang T, Qi XX, Chi JC et al (2018) Clinical outcome in elderly Chinese patients with primary hepatocellular carcinoma treated with percutaneous microwave coagulation therapy (PMCT) a strobe-compliant observational study. Medicine 97(35):e11618
doi: 10.1097/MD.0000000000011618
pubmed: 30170369
pmcid: 6393083
Shi F, Lian SS, Mai QC, Mo ZQ, Zhuang WH, Cui W et al (2020) Microwave ablation after downstaging of hepatocellular carcinoma: outcome was similar to tumor within Milan criteria. Eur Radiol 30(5):2454–2462
doi: 10.1007/s00330-019-06604-y
pubmed: 32002636
Shi Y, Wang Z, Chi J, Shi D, Wang T, Cui D et al (2020) Long-term results of percutaneous microwave ablation for colorectal liver metastases. HPB (Oxford) 23(1):37–45
doi: 10.1016/j.hpb.2020.04.007
pubmed: 32561175
Soliman AF, Abouelkhair MM, Hasab Allah MS, El-Kady NM, Ezzat WM, Gabr HA et al (2019) Efficacy and safety of microwave ablation (MWA) for hepatocellular carcinoma (HCC) in difficult anatomical sites in egyptian patients with liver cirrhosis. Asian Pac J Cancer Prev 20(1):295–301
doi: 10.31557/APJCP.2019.20.1.295
pubmed: 30678453
pmcid: 6485570
Sparchez Z, Mocan T, Hajjar NA, Bartos A, Hagiu C, Matei D et al (2019) Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases a monocentric initial experience. Med Ultrason 21(3):217–224
doi: 10.11152/mu-1957
pubmed: 31476199
Sun AX, Cheng ZL, Wu PP, Sheng YH, Qu XJ, Lu W et al (2015) Clinical outcome of medium-sized hepatocellular carcinoma treated with microwave ablation. World J Gastroenterol 21(10):2997–3004
doi: 10.3748/wjg.v21.i10.2997
pubmed: 25780298
pmcid: 4356920
Tang X, Ding M, Lu B, Chi J, Wang T, Shi Y et al (2019) Outcomes of ultrasound-guided percutaneous microwave ablation versus surgical resection for symptomatic large hepatic hemangiomas. Int J Hyperthermia 36(1):632–639
doi: 10.1080/02656736.2019.1624837
pubmed: 31244349
Thamtorawat S, Hicks RM, Yu J, Siripongsakun S, Lin WC, Raman SS et al (2016) Preliminary outcome of microwave ablation of hepatocellular carcinoma: breaking the 3-cm barrier? J Vasc Interv Radiol 27(5):623–630
doi: 10.1016/j.jvir.2016.01.011
pubmed: 27013403
Vietti Violi N, Duran R, Guiu B, Cercueil JP, Aube C, Digklia A et al (2018) Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial. Lancet Gastroenterol Hepatol 3(5):317–325
doi: 10.1016/S2468-1253(18)30029-3
pubmed: 29503247
Vo Chieu VD, Werncke T, Hensen B, Wacker F, Ringe KI (2018) CT-Guided Microwave ablation of liver tumors in anatomically challenging locations. Cardiovasc Intervent Radiol 41(10):1520–1529
doi: 10.1007/s00270-018-2007-z
pubmed: 29948004
Wang J, Liang P, Yu J, Yu MA, Liu F, Cheng Z et al (2014) Clinical outcome of ultrasound-guided percutaneous microwave ablation on colorectal liver metastases. Oncol Lett 8(1):323–326
doi: 10.3892/ol.2014.2106
pubmed: 24959270
pmcid: 4063642
Weiss J, Winkelmann MT, Gohla G, Kubler J, Clasen S, Nikolaou K et al (2020) MR-guided microwave ablation in hepatic malignancies: clinical experiences from 50 procedures. Int J Hyperthermia 37(1):349–355
doi: 10.1080/02656736.2020.1750713
pubmed: 32286087
Xu C, Li L, Xu W, Du C, Yang L, Tong J et al (2019) Ultrasound-guided percutaneous microwave ablation versus surgical resection for recurrent intrahepatic cholangiocarcinoma: intermediate-term results. Int J Hyperthermia 36(1):351–358
doi: 10.1080/02656736.2019.1571247
pubmed: 30845852
Yang HC, Yang Y, Dou JP, Cui R, Cheng ZG, Han ZY et al (2020) Cholecystectomy is associated with higher risk of recurrence after microwave ablation of hepatocellular carcinoma: a propensity score matching analysis. Cancer Biol Med 17(2):478–491
doi: 10.20892/j.issn.2095-3941.2019.0246
pubmed: 32587783
pmcid: 7309471
Zhang K, Yu J, Yu XL, Han ZY, Cheng ZG, Liu FY et al (2018) Clinical and survival outcomes of percutaneous microwave ablation for intrahepatic cholangiocarcinoma. Int J Hyperth 34(3):292–297
doi: 10.1080/02656736.2017.1327678
Chinnaratha MA, Chuang MA, Fraser RJL, Woodman RJ, Wigg AJ (2016) Percutaneous thermal ablation for primary hepatocellular carcinoma: a systematic review and meta-analysis. J Gastroenterol Hepatol 31(2):294–301
doi: 10.1111/jgh.13028
pubmed: 26114968
Ruiter SJS, Heerink WJ, de Jong KP (2019) Liver microwave ablation: a systematic review of various FDA-approved systems. Eur Radiol 29(8):4026–4035
doi: 10.1007/s00330-018-5842-z
pubmed: 30506218
Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE et al (2009) Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 20(7 Suppl):S377–S390
doi: 10.1016/j.jvir.2009.04.011
pubmed: 19560026
North DA, Groeschl RT, Sindram D, Martinie JB, Iannitti DA, Bloomston M et al (2014) Microwave ablation for hepatic malignancies: a call for standard reporting and outcomes. Am J Surg 208(2):284–294
doi: 10.1016/j.amjsurg.2014.02.002
pubmed: 24970652
Fromer MW, Scoggins CR, Egger ME, Philips P, McMasters KM, Martin Ii RCG (2022) Preventing futile liver resection: a risk-based approach to surgical selection in major hepatectomy for colorectal cancer. Ann Surg Oncol 29(2):905–912
doi: 10.1245/s10434-021-10761-0
pubmed: 34522997