A Preliminary Study Of Effect Of Microwave Ablation On Hepatocellular Carcinoma In Post-Hepatitis C Cirrhotic Patients
Nesrine El-Sadek Ahmed Makhlouf;
Abstract
Multiple percutaneous ablation methods are now available for hepatocellular carcinoma (HCC) either as primary treatment or for bridging to transplantation. Newer technologies are being evaluated and may change future practice patterns.
Microwave ablation (MWA) is the fastest growing ablation modality for the treatment of HCC.MWA appears to be less susceptible to heat sink effects than RFA. For this reason, the use of microwave ablation for tumors near the hepatic veins and IVC may be more effective. Other advantages over RFA include the capacity to heat charred tissues and the lack of grounding pads. In addition, in preclinical studies, microwaves can achieve larger zones of ablation with faster ablation times.
To fulfill the aim of the work, this study was designed to assess the efficacy and safety of Microwave Ablation as one of the local modality for the treatment of Hepatocellular Carcinoma.
This study was conductedin co-operation between Tropical Medicine Department Ain-Shams University and The National Hepatology and Tropical Medicine Research Institute, Cairo. It included patients who were attending the outpatient clinic at Ain shams University Specialized Hospital as well as Intervention Unit at The National Hepatology and Tropical Medicine Research Institute in Cairo from August 2011 to September 2013. We performed our study on 20 patients with proven chronic hepatitis C virus infection and hepatocellular carcinoma that fulfill the pre-designed inclusion criteria.
All patients were subjected to the following; careful history taking, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood count, viral markers (HCV-Ab and HBs-Ag), renal function tests (blood urea nitrogen and serum creatinine) and AFP]. Abdominal ultrasound and spiral CT scan were done for all cases. Then MWA was performed for all cases.
Concerning the clinical presentation, the majority of cases (85%) were accidentally discovered. Abdominal pain was reported in only 15% of our cases.
The current study reveals that serum AFP significantly decreased 1 month after MWA.
There was no significant change in either Child Classification or BCLC (Barcelona Clinic Liver Cancer) one month after MWA.
Concerning Response of studied cases 1 month after MWA, 70% of them showed complete response one month after MWA while those showing partial and progressive responses were 25% and 5%, respectively.
The present study reveals that complete response is achieved in 10 cases(71.4%) with lesion ≤ 3cmandin4 cases(28.6%)with lesion > 3cm. So, MWA is preferablein those with lesions ≤ 3cm.
Few complications were encountered in the current study;abdominal pain was reported in 12 cases (60%) as well as fever which was present in 3 patients only (15%).
Therefore, sonographically guided percutaneous microwave ablation proved to be safe andeffective for the treatment of hepatocellular carcinoma. So, it is of considerable clinical significance.
Microwave ablation (MWA) is the fastest growing ablation modality for the treatment of HCC.MWA appears to be less susceptible to heat sink effects than RFA. For this reason, the use of microwave ablation for tumors near the hepatic veins and IVC may be more effective. Other advantages over RFA include the capacity to heat charred tissues and the lack of grounding pads. In addition, in preclinical studies, microwaves can achieve larger zones of ablation with faster ablation times.
To fulfill the aim of the work, this study was designed to assess the efficacy and safety of Microwave Ablation as one of the local modality for the treatment of Hepatocellular Carcinoma.
This study was conductedin co-operation between Tropical Medicine Department Ain-Shams University and The National Hepatology and Tropical Medicine Research Institute, Cairo. It included patients who were attending the outpatient clinic at Ain shams University Specialized Hospital as well as Intervention Unit at The National Hepatology and Tropical Medicine Research Institute in Cairo from August 2011 to September 2013. We performed our study on 20 patients with proven chronic hepatitis C virus infection and hepatocellular carcinoma that fulfill the pre-designed inclusion criteria.
All patients were subjected to the following; careful history taking, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood count, viral markers (HCV-Ab and HBs-Ag), renal function tests (blood urea nitrogen and serum creatinine) and AFP]. Abdominal ultrasound and spiral CT scan were done for all cases. Then MWA was performed for all cases.
Concerning the clinical presentation, the majority of cases (85%) were accidentally discovered. Abdominal pain was reported in only 15% of our cases.
The current study reveals that serum AFP significantly decreased 1 month after MWA.
There was no significant change in either Child Classification or BCLC (Barcelona Clinic Liver Cancer) one month after MWA.
Concerning Response of studied cases 1 month after MWA, 70% of them showed complete response one month after MWA while those showing partial and progressive responses were 25% and 5%, respectively.
The present study reveals that complete response is achieved in 10 cases(71.4%) with lesion ≤ 3cmandin4 cases(28.6%)with lesion > 3cm. So, MWA is preferablein those with lesions ≤ 3cm.
Few complications were encountered in the current study;abdominal pain was reported in 12 cases (60%) as well as fever which was present in 3 patients only (15%).
Therefore, sonographically guided percutaneous microwave ablation proved to be safe andeffective for the treatment of hepatocellular carcinoma. So, it is of considerable clinical significance.
Other data
| Title | A Preliminary Study Of Effect Of Microwave Ablation On Hepatocellular Carcinoma In Post-Hepatitis C Cirrhotic Patients | Other Titles | دراسة أولية لتأثير موجات الميكروويف على سرطان الكبد لمرضى التليف الكبدي الناتج عن الفيروس الكبدي (سي) | Authors | Nesrine El-Sadek Ahmed Makhlouf | Issue Date | 2015 |
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