Objective To evaluate the long-term efficacy of percutaneous microwave ablation(MWA)therapy for hepatocellular carcinoma.Methods 2054 cases with Barcelona Clinic Liver Cancer(BCLC)stage 0～B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected.All patients were followed up for at least 2 years.The primary endpoint of overall survival and secondary endpoints(tumor-related survival,disease-free survival,and postoperative complications)of patients treated with ultrasound-guided percutaneous MWA were analyzed.Kaplan-Meier method was used for stratified survival rate analysis.Fine-and-Gray competing risk model was used to analyze overall survival.Results A total of 5 503 HCC nodules[mean tumor diameter(2.6±1.6)cm]underwent 3 908 MWAs between January 2006 and September 2020,with a median follow-up time of 45.6(24.0-79.2)months.The technical effectiveness rate of 5 375 tumor nodules was 97.5％.The overall survival rates at 5,10,and 15-years were 61.6％,38.8％,and 27.0％,respectively.The tumor-specific survival rates were 67.1％,47.2％,and 37.7％,respectively.The free tumor survival rates were 25.8％,15.7％,and 9.9％,respectively.The incidence rate of severe complications was 2.8％(108/3 908).Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010,2011-2015,and 2016-September 2020 were significantly increased,with P＜0.001,especially for liver cancer 3.1～5.0 cm(P＜0.001).Conclusion Microwave ablation therapy is a safe and effective method for BCLC stage 0-B,with significantly enhanced technical efficacy and survival rate over time.
维普
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