Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis
Background Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous ra...
Gespeichert in:
| Veröffentlicht in: | Annals of surgical oncology 2025-02, Vol.32 (2), p.1063-1072 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1072 |
|---|---|
| container_issue | 2 |
| container_start_page | 1063 |
| container_title | Annals of surgical oncology |
| container_volume | 32 |
| creator | Cillo, Umberto Caregari, Silvia Barabino, Matteo Billato, Ilaria Marchini, Andrea Furlanetto, Alessandro Lazzari, Sara Brolese, Marco Ballo, Mattia Biasini, Elisabetta Celsa, Ciro Sangiovanni, Angelo Foschi, Francesco Giuseppe Campani, Claudia Vidili, Gianpaolo Saitta, Carlo Piscaglia, Fabio Brunetto, Maurizia Rossana Masotto, Alberto Farinati, Fabio Trevisani, Franco Zappa, Marco Antonio Vitale, Alessandro Santambrogio, Roberto |
| description | Background
Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous radiofrequency ablation (PRFA) as the reference treatment.
Methods
A retrospective multicenter observational study was conducted, enrolling non-transplantable, non-resectable patients who had early HCC treated with LMWA (
n
= 658) from Padua and Milan centers, and with PRFA (
n
= 844), and TACE (
n
= 425) from the ITA.LI.CA multicenter database. The matching-adjusted indirect comparison (MAIC) method was used to obtain weighted LMWA and TACE populations similar to the reference PRFA population.
Results
Laparoscopic ablation showed an excellent safety profile, and MAIC-weighted early postoperative deaths were comparable among the groups. The MAIC-weighted overall survival was similar between the LMWA (1-, 3-, and 5 year survival of 91.0 %, 67.9 %, 47.0 %, respectively) and PRFA (1-, 3- and 5 year survivals of 90.0 %, 64.7 %, 46.6 %, respectively) groups (
p
= 0.678) and significantly better for the LMWA group than for the TACE group (1-, 3- and 5 year survivals of 84.7 %, 48.8 %, 33.6 %, respectively) (
p
< 0.001). Weighted multivariate overall survival analysis and competing risk/subgroup analyses confirmed the non-inferiority of LMWA to PRFA and its superiority to TACE. The LMWA- and PRFA-treated patients had a significantly lower risk of HCC-related death (
p
= 0.004) than the TACE-treated patients (
p
= 0.001). Conversely, the groups did not differ significantly in terms of non-HCC-related deaths.
Conclusions
The non-inferiority of LMWA to PRFA, its superiority to TACE, and its applicability to a wide range of presentations with few contraindications support its inclusion among radical therapies for treating early-HCC patients. |
| doi_str_mv | 10.1245/s10434-024-16462-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146609955</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3151305818</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-b822fc6cf4a5f27b87b73554d6babba69f9fcf2fc779b99af8926084fa961f293</originalsourceid><addsrcrecordid>eNp9kcGOFCEQhonRuOvqC3gwJF68tAINNHibTFbHZIxG1zMpWNhh09200K2ZF_F5pZ1VEw-eIPDVV5X6EXpKyUvKuHhVKOEtbwjjDZVcskbdQ-dU1CcuFb1f70SqRjMpztCjUm4JoV1LxEN01mopZKvpOfqxiz5DdofooO-P-GMqcY5pjOMN3sMEORWXpujw--hy-g7fPN7YHlYExxHPB4-vDtUw-WWu1OcJRpwCvoRcZTs_wZyc7_ulh4y3tU8c0wCv8QZ_8tA3-xg83qah9qnK1T1CfyyxPEYPAvTFP7k7L9CXN5dX212z__D23XazbxwTcm6sYiw46QIHEVhnVWe7Vgh-LS1YC1IHHVyoSNdpqzUEVbdBFA-gJQ1Mtxfoxck75fR18WU2QyzrwDD6tBTTUi4l0VqIij7_B71NS67zrpSgdbGKqkqxE1W3VUr2wUw5DpCPhhKzpmZOqZmamvmVmlmLnt2pFzv46z8lv2OqQHsCSv0ab3z-2_s_2p-bSKTn</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3151305818</pqid></control><display><type>article</type><title>Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Cillo, Umberto ; Caregari, Silvia ; Barabino, Matteo ; Billato, Ilaria ; Marchini, Andrea ; Furlanetto, Alessandro ; Lazzari, Sara ; Brolese, Marco ; Ballo, Mattia ; Biasini, Elisabetta ; Celsa, Ciro ; Sangiovanni, Angelo ; Foschi, Francesco Giuseppe ; Campani, Claudia ; Vidili, Gianpaolo ; Saitta, Carlo ; Piscaglia, Fabio ; Brunetto, Maurizia Rossana ; Masotto, Alberto ; Farinati, Fabio ; Trevisani, Franco ; Zappa, Marco Antonio ; Vitale, Alessandro ; Santambrogio, Roberto</creator><creatorcontrib>Cillo, Umberto ; Caregari, Silvia ; Barabino, Matteo ; Billato, Ilaria ; Marchini, Andrea ; Furlanetto, Alessandro ; Lazzari, Sara ; Brolese, Marco ; Ballo, Mattia ; Biasini, Elisabetta ; Celsa, Ciro ; Sangiovanni, Angelo ; Foschi, Francesco Giuseppe ; Campani, Claudia ; Vidili, Gianpaolo ; Saitta, Carlo ; Piscaglia, Fabio ; Brunetto, Maurizia Rossana ; Masotto, Alberto ; Farinati, Fabio ; Trevisani, Franco ; Zappa, Marco Antonio ; Vitale, Alessandro ; Santambrogio, Roberto ; ITA.LI.CA Study Group ; The ITA.LI.CA Study Group</creatorcontrib><description>Background
Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous radiofrequency ablation (PRFA) as the reference treatment.
Methods
A retrospective multicenter observational study was conducted, enrolling non-transplantable, non-resectable patients who had early HCC treated with LMWA (
n
= 658) from Padua and Milan centers, and with PRFA (
n
= 844), and TACE (
n
= 425) from the ITA.LI.CA multicenter database. The matching-adjusted indirect comparison (MAIC) method was used to obtain weighted LMWA and TACE populations similar to the reference PRFA population.
Results
Laparoscopic ablation showed an excellent safety profile, and MAIC-weighted early postoperative deaths were comparable among the groups. The MAIC-weighted overall survival was similar between the LMWA (1-, 3-, and 5 year survival of 91.0 %, 67.9 %, 47.0 %, respectively) and PRFA (1-, 3- and 5 year survivals of 90.0 %, 64.7 %, 46.6 %, respectively) groups (
p
= 0.678) and significantly better for the LMWA group than for the TACE group (1-, 3- and 5 year survivals of 84.7 %, 48.8 %, 33.6 %, respectively) (
p
< 0.001). Weighted multivariate overall survival analysis and competing risk/subgroup analyses confirmed the non-inferiority of LMWA to PRFA and its superiority to TACE. The LMWA- and PRFA-treated patients had a significantly lower risk of HCC-related death (
p
= 0.004) than the TACE-treated patients (
p
= 0.001). Conversely, the groups did not differ significantly in terms of non-HCC-related deaths.
Conclusions
The non-inferiority of LMWA to PRFA, its superiority to TACE, and its applicability to a wide range of presentations with few contraindications support its inclusion among radical therapies for treating early-HCC patients.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-16462-8</identifier><identifier>PMID: 39656391</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Ablation ; Aged ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Carcinoma, Hepatocellular - therapy ; Catheter Ablation - methods ; Chemoembolization, Therapeutic - methods ; Comparative analysis ; Female ; Follow-Up Studies ; Hepatobiliary Tumors ; Hepatocellular carcinoma ; Humans ; Laparoscopy ; Laparoscopy - methods ; Liver cancer ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Liver Neoplasms - therapy ; Male ; Medicine ; Medicine & Public Health ; Microwave ablation ; Microwaves - therapeutic use ; Middle Aged ; Oncology ; Prognosis ; Radiofrequency Ablation - methods ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival ; Survival analysis ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2025-02, Vol.32 (2), p.1063-1072</ispartof><rights>Society of Surgical Oncology 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Society of Surgical Oncology.</rights><rights>Copyright Springer Nature B.V. Feb 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-b822fc6cf4a5f27b87b73554d6babba69f9fcf2fc779b99af8926084fa961f293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-024-16462-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-024-16462-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39656391$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cillo, Umberto</creatorcontrib><creatorcontrib>Caregari, Silvia</creatorcontrib><creatorcontrib>Barabino, Matteo</creatorcontrib><creatorcontrib>Billato, Ilaria</creatorcontrib><creatorcontrib>Marchini, Andrea</creatorcontrib><creatorcontrib>Furlanetto, Alessandro</creatorcontrib><creatorcontrib>Lazzari, Sara</creatorcontrib><creatorcontrib>Brolese, Marco</creatorcontrib><creatorcontrib>Ballo, Mattia</creatorcontrib><creatorcontrib>Biasini, Elisabetta</creatorcontrib><creatorcontrib>Celsa, Ciro</creatorcontrib><creatorcontrib>Sangiovanni, Angelo</creatorcontrib><creatorcontrib>Foschi, Francesco Giuseppe</creatorcontrib><creatorcontrib>Campani, Claudia</creatorcontrib><creatorcontrib>Vidili, Gianpaolo</creatorcontrib><creatorcontrib>Saitta, Carlo</creatorcontrib><creatorcontrib>Piscaglia, Fabio</creatorcontrib><creatorcontrib>Brunetto, Maurizia Rossana</creatorcontrib><creatorcontrib>Masotto, Alberto</creatorcontrib><creatorcontrib>Farinati, Fabio</creatorcontrib><creatorcontrib>Trevisani, Franco</creatorcontrib><creatorcontrib>Zappa, Marco Antonio</creatorcontrib><creatorcontrib>Vitale, Alessandro</creatorcontrib><creatorcontrib>Santambrogio, Roberto</creatorcontrib><creatorcontrib>ITA.LI.CA Study Group</creatorcontrib><creatorcontrib>The ITA.LI.CA Study Group</creatorcontrib><title>Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous radiofrequency ablation (PRFA) as the reference treatment.
Methods
A retrospective multicenter observational study was conducted, enrolling non-transplantable, non-resectable patients who had early HCC treated with LMWA (
n
= 658) from Padua and Milan centers, and with PRFA (
n
= 844), and TACE (
n
= 425) from the ITA.LI.CA multicenter database. The matching-adjusted indirect comparison (MAIC) method was used to obtain weighted LMWA and TACE populations similar to the reference PRFA population.
Results
Laparoscopic ablation showed an excellent safety profile, and MAIC-weighted early postoperative deaths were comparable among the groups. The MAIC-weighted overall survival was similar between the LMWA (1-, 3-, and 5 year survival of 91.0 %, 67.9 %, 47.0 %, respectively) and PRFA (1-, 3- and 5 year survivals of 90.0 %, 64.7 %, 46.6 %, respectively) groups (
p
= 0.678) and significantly better for the LMWA group than for the TACE group (1-, 3- and 5 year survivals of 84.7 %, 48.8 %, 33.6 %, respectively) (
p
< 0.001). Weighted multivariate overall survival analysis and competing risk/subgroup analyses confirmed the non-inferiority of LMWA to PRFA and its superiority to TACE. The LMWA- and PRFA-treated patients had a significantly lower risk of HCC-related death (
p
= 0.004) than the TACE-treated patients (
p
= 0.001). Conversely, the groups did not differ significantly in terms of non-HCC-related deaths.
Conclusions
The non-inferiority of LMWA to PRFA, its superiority to TACE, and its applicability to a wide range of presentations with few contraindications support its inclusion among radical therapies for treating early-HCC patients.</description><subject>Ablation</subject><subject>Aged</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Catheter Ablation - methods</subject><subject>Chemoembolization, Therapeutic - methods</subject><subject>Comparative analysis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatobiliary Tumors</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Neoplasms - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microwave ablation</subject><subject>Microwaves - therapeutic use</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Radiofrequency Ablation - methods</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGOFCEQhonRuOvqC3gwJF68tAINNHibTFbHZIxG1zMpWNhh09200K2ZF_F5pZ1VEw-eIPDVV5X6EXpKyUvKuHhVKOEtbwjjDZVcskbdQ-dU1CcuFb1f70SqRjMpztCjUm4JoV1LxEN01mopZKvpOfqxiz5DdofooO-P-GMqcY5pjOMN3sMEORWXpujw--hy-g7fPN7YHlYExxHPB4-vDtUw-WWu1OcJRpwCvoRcZTs_wZyc7_ulh4y3tU8c0wCv8QZ_8tA3-xg83qah9qnK1T1CfyyxPEYPAvTFP7k7L9CXN5dX212z__D23XazbxwTcm6sYiw46QIHEVhnVWe7Vgh-LS1YC1IHHVyoSNdpqzUEVbdBFA-gJQ1Mtxfoxck75fR18WU2QyzrwDD6tBTTUi4l0VqIij7_B71NS67zrpSgdbGKqkqxE1W3VUr2wUw5DpCPhhKzpmZOqZmamvmVmlmLnt2pFzv46z8lv2OqQHsCSv0ab3z-2_s_2p-bSKTn</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Cillo, Umberto</creator><creator>Caregari, Silvia</creator><creator>Barabino, Matteo</creator><creator>Billato, Ilaria</creator><creator>Marchini, Andrea</creator><creator>Furlanetto, Alessandro</creator><creator>Lazzari, Sara</creator><creator>Brolese, Marco</creator><creator>Ballo, Mattia</creator><creator>Biasini, Elisabetta</creator><creator>Celsa, Ciro</creator><creator>Sangiovanni, Angelo</creator><creator>Foschi, Francesco Giuseppe</creator><creator>Campani, Claudia</creator><creator>Vidili, Gianpaolo</creator><creator>Saitta, Carlo</creator><creator>Piscaglia, Fabio</creator><creator>Brunetto, Maurizia Rossana</creator><creator>Masotto, Alberto</creator><creator>Farinati, Fabio</creator><creator>Trevisani, Franco</creator><creator>Zappa, Marco Antonio</creator><creator>Vitale, Alessandro</creator><creator>Santambrogio, Roberto</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20250201</creationdate><title>Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis</title><author>Cillo, Umberto ; Caregari, Silvia ; Barabino, Matteo ; Billato, Ilaria ; Marchini, Andrea ; Furlanetto, Alessandro ; Lazzari, Sara ; Brolese, Marco ; Ballo, Mattia ; Biasini, Elisabetta ; Celsa, Ciro ; Sangiovanni, Angelo ; Foschi, Francesco Giuseppe ; Campani, Claudia ; Vidili, Gianpaolo ; Saitta, Carlo ; Piscaglia, Fabio ; Brunetto, Maurizia Rossana ; Masotto, Alberto ; Farinati, Fabio ; Trevisani, Franco ; Zappa, Marco Antonio ; Vitale, Alessandro ; Santambrogio, Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-b822fc6cf4a5f27b87b73554d6babba69f9fcf2fc779b99af8926084fa961f293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Ablation</topic><topic>Aged</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Catheter Ablation - methods</topic><topic>Chemoembolization, Therapeutic - methods</topic><topic>Comparative analysis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatobiliary Tumors</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Neoplasms - therapy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microwave ablation</topic><topic>Microwaves - therapeutic use</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Radiofrequency Ablation - methods</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cillo, Umberto</creatorcontrib><creatorcontrib>Caregari, Silvia</creatorcontrib><creatorcontrib>Barabino, Matteo</creatorcontrib><creatorcontrib>Billato, Ilaria</creatorcontrib><creatorcontrib>Marchini, Andrea</creatorcontrib><creatorcontrib>Furlanetto, Alessandro</creatorcontrib><creatorcontrib>Lazzari, Sara</creatorcontrib><creatorcontrib>Brolese, Marco</creatorcontrib><creatorcontrib>Ballo, Mattia</creatorcontrib><creatorcontrib>Biasini, Elisabetta</creatorcontrib><creatorcontrib>Celsa, Ciro</creatorcontrib><creatorcontrib>Sangiovanni, Angelo</creatorcontrib><creatorcontrib>Foschi, Francesco Giuseppe</creatorcontrib><creatorcontrib>Campani, Claudia</creatorcontrib><creatorcontrib>Vidili, Gianpaolo</creatorcontrib><creatorcontrib>Saitta, Carlo</creatorcontrib><creatorcontrib>Piscaglia, Fabio</creatorcontrib><creatorcontrib>Brunetto, Maurizia Rossana</creatorcontrib><creatorcontrib>Masotto, Alberto</creatorcontrib><creatorcontrib>Farinati, Fabio</creatorcontrib><creatorcontrib>Trevisani, Franco</creatorcontrib><creatorcontrib>Zappa, Marco Antonio</creatorcontrib><creatorcontrib>Vitale, Alessandro</creatorcontrib><creatorcontrib>Santambrogio, Roberto</creatorcontrib><creatorcontrib>ITA.LI.CA Study Group</creatorcontrib><creatorcontrib>The ITA.LI.CA Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cillo, Umberto</au><au>Caregari, Silvia</au><au>Barabino, Matteo</au><au>Billato, Ilaria</au><au>Marchini, Andrea</au><au>Furlanetto, Alessandro</au><au>Lazzari, Sara</au><au>Brolese, Marco</au><au>Ballo, Mattia</au><au>Biasini, Elisabetta</au><au>Celsa, Ciro</au><au>Sangiovanni, Angelo</au><au>Foschi, Francesco Giuseppe</au><au>Campani, Claudia</au><au>Vidili, Gianpaolo</au><au>Saitta, Carlo</au><au>Piscaglia, Fabio</au><au>Brunetto, Maurizia Rossana</au><au>Masotto, Alberto</au><au>Farinati, Fabio</au><au>Trevisani, Franco</au><au>Zappa, Marco Antonio</au><au>Vitale, Alessandro</au><au>Santambrogio, Roberto</au><aucorp>ITA.LI.CA Study Group</aucorp><aucorp>The ITA.LI.CA Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>32</volume><issue>2</issue><spage>1063</spage><epage>1072</epage><pages>1063-1072</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background
Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous radiofrequency ablation (PRFA) as the reference treatment.
Methods
A retrospective multicenter observational study was conducted, enrolling non-transplantable, non-resectable patients who had early HCC treated with LMWA (
n
= 658) from Padua and Milan centers, and with PRFA (
n
= 844), and TACE (
n
= 425) from the ITA.LI.CA multicenter database. The matching-adjusted indirect comparison (MAIC) method was used to obtain weighted LMWA and TACE populations similar to the reference PRFA population.
Results
Laparoscopic ablation showed an excellent safety profile, and MAIC-weighted early postoperative deaths were comparable among the groups. The MAIC-weighted overall survival was similar between the LMWA (1-, 3-, and 5 year survival of 91.0 %, 67.9 %, 47.0 %, respectively) and PRFA (1-, 3- and 5 year survivals of 90.0 %, 64.7 %, 46.6 %, respectively) groups (
p
= 0.678) and significantly better for the LMWA group than for the TACE group (1-, 3- and 5 year survivals of 84.7 %, 48.8 %, 33.6 %, respectively) (
p
< 0.001). Weighted multivariate overall survival analysis and competing risk/subgroup analyses confirmed the non-inferiority of LMWA to PRFA and its superiority to TACE. The LMWA- and PRFA-treated patients had a significantly lower risk of HCC-related death (
p
= 0.004) than the TACE-treated patients (
p
= 0.001). Conversely, the groups did not differ significantly in terms of non-HCC-related deaths.
Conclusions
The non-inferiority of LMWA to PRFA, its superiority to TACE, and its applicability to a wide range of presentations with few contraindications support its inclusion among radical therapies for treating early-HCC patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39656391</pmid><doi>10.1245/s10434-024-16462-8</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2025-02, Vol.32 (2), p.1063-1072 |
| issn | 1068-9265 1534-4681 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3146609955 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Ablation Aged Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Carcinoma, Hepatocellular - therapy Catheter Ablation - methods Chemoembolization, Therapeutic - methods Comparative analysis Female Follow-Up Studies Hepatobiliary Tumors Hepatocellular carcinoma Humans Laparoscopy Laparoscopy - methods Liver cancer Liver Neoplasms - pathology Liver Neoplasms - surgery Liver Neoplasms - therapy Male Medicine Medicine & Public Health Microwave ablation Microwaves - therapeutic use Middle Aged Oncology Prognosis Radiofrequency Ablation - methods Retrospective Studies Surgery Surgical Oncology Survival Survival analysis Survival Rate |
| title | Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T01%3A12%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hierarchically%20Positioning%20Laparoscopic%20Microwave%20Ablation%20in%20the%20Therapeutic%20Span%20of%20Early%20Hepatocellular%20Carcinoma:%20A%20Real-Life%20Comparative%20Analysis&rft.jtitle=Annals%20of%20surgical%20oncology&rft.au=Cillo,%20Umberto&rft.aucorp=ITA.LI.CA%20Study%20Group&rft.date=2025-02-01&rft.volume=32&rft.issue=2&rft.spage=1063&rft.epage=1072&rft.pages=1063-1072&rft.issn=1068-9265&rft.eissn=1534-4681&rft_id=info:doi/10.1245/s10434-024-16462-8&rft_dat=%3Cproquest_cross%3E3151305818%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3151305818&rft_id=info:pmid/39656391&rfr_iscdi=true |