Abstract
Comparison of Complications of Radiofrequency Ablation and Microwave Ablation in Patients with Hepatocellular Carcinoma
Elisa Francesca G. Mendoza, MD; Stephen N. Wong, MD
Chinese General Hospital and Medical Center
Significance: Hepatocellular carcinoma (HCC) is the most common primary liver cancer. This study compares complication rates between radiofrequency ablation (RFA) and microwave ablation (MWA) in HCC patients and identifies factors predictive of complications.
Methodology: Consecutive patients from 2007-2023 who underwent RFA or MWA were included. Major complications include death, seeding, and any complication that warranted prolonged hospital stay or instrumentation to be done. The rest were considered minor complications.
Results: Among RFA patients, 17/319 (5.3%) experienced major complications, compared to 4/92 (4.3%) in the MWA group (p=0.706). Minor complications occurred in 24/319 RFA patients (7.5%) and 8/92 MWA patients (8.7%) (p=0.712). A bigger tumor size was significantly associated with an increased likelihood of both major (p=0.049) and minor complications (p=0.020). Patients receiving antibiotic prophylaxis had a higher rate of minor complications (60% vs 32.5%; p=0.003). The most common minor complication overall was fever (2.7%), followed by pleural effusion (2.2%). For major complications, abscess formation was the most frequent (2.2%), followed by tumor seeding and organ damage (1%). On multivariate analysis, only total ablation time emerged as a predictor of major complications (OR=0.968;95%CI=0.948-0.989;p=0.003). No independent predictors of minor complications were identified.
Conclusion: Both RFA and MWA had low major and minor complication rates. The fact that total ablation time was an independent predictor of major complications emphasizes the need for careful consideration of procedural duration to minimize risks.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |