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Percutaneous US-guided MWA of small liver HCC: predictors of outcome and risk factors for complications from a single center experience

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Abstract

The aim of the present study was to identify predictors of outcome and complications in patients with small hepatocellular carcinoma (HCC) treated by percutaneous microwave ablation (MWA). Patients with non-previously treated small (≤ 3 cm) HCCs who underwent ultrasound (US)-guided percutaneous MWA between July 2016 and January 2019 were included. For each patient, the following variables were registered: age, sex, albumin, platelet count, INR/PT, PTT ratio, total bilirubin, liver status, etiology of liver disease, Child–Pugh classification, tumor dimension, margin, and hepatic segment, tumor subcapsular, perihilar or perivascular location, HCC focality, ascites. During follow-up, complications and outcomes were registered. Variables were then analyzed in relation to both outcomes and complications. 74 patients were included. Mean CT follow-up was 6.2 months (range 1–24 months). At least one complication occurred in 48% of patients, the majority being asymptomatic imaging findings not requiring intervention. One major complication was registered (duodenal perforation: 1.3%). The occurrence of complications was associated with HCC multifocality and abnormal INR/PT, duodenal wall edema with tumor dimension, portal vein thrombosis with Child Pugh score, perihepatic free fluid with abnormal platelet count and comorbidities. Incomplete response rate at 1 month was 18.9%. Local tumor progression and new HCC nodules rates were 13.5% and 27%, respectively. Incomplete response at 1 month was associated with both alcoholic etiology of liver disease and II segment tumor location, new HCC nodules with PBC. Despite the small series analyzed, significant factors related with complications and outcomes may be kept in mind when planning the best treatment for each patient.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Postgraduate School in Radiology, University of Milan, Milan, Italy

    Pierpaolo Biondetti, Enrico Maria Fumarola, Giovanna Gorga, Luca Maggi & Elena Valconi

  2. Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, Milan, Italy

    Anna Maria Ierardi, Salvatore Alessio Angileri & Gianpaolo Carrafiello

  3. Radiology Department, ASST Sette Laghi, Varese, Italy

    Andrea Coppola

Authors
  1. Pierpaolo Biondetti
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  2. Enrico Maria Fumarola
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  3. Anna Maria Ierardi
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  6. Luca Maggi
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  9. Gianpaolo Carrafiello
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by all authors. The manuscript was written by all authors, who also commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Pierpaolo Biondetti.

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Biondetti, P., Fumarola, E.M., Ierardi, A.M. et al. Percutaneous US-guided MWA of small liver HCC: predictors of outcome and risk factors for complications from a single center experience. Med Oncol 37, 39 (2020). https://doi.org/10.1007/s12032-020-01365-x

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