New next-generation microwave thermosphere ablation for small hepatocellular carcinoma

Background/Aims In July 2017, the Emprint™ next-generation microwave ablation system using thermosphere technology (Covidien, Boulder, CO, USA) was approved for use in Japan. This system can produce a predictable spherical ablation zone at higher temperatures than radiofrequency ablation (RFA). The...

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Main Authors: Hideyuki Tamai, Jumpei Okamura
Format: Article
Language:English
Published: Korean Association for the Study of the Liver 2021-10-01
Series:Clinical and Molecular Hepatology
Subjects:
Online Access:http://e-cmh.org/upload/pdf/cmh-2021-0136.pdf
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author Hideyuki Tamai
Jumpei Okamura
author_facet Hideyuki Tamai
Jumpei Okamura
author_sort Hideyuki Tamai
collection DOAJ
description Background/Aims In July 2017, the Emprint™ next-generation microwave ablation system using thermosphere technology (Covidien, Boulder, CO, USA) was approved for use in Japan. This system can produce a predictable spherical ablation zone at higher temperatures than radiofrequency ablation (RFA). The aim of the present study was to elucidate whether this new microwave thermosphere ablation (MTA) could safely improve outcome compared to RFA, which is the standard of care for small hepatocellular carcinoma (HCC). Methods This retrospective study analyzed 513 patients with 630 HCCs (≤3 cm) who were performed by percutaneous RFA (174 patients, 214 HCCs) or MTA (339 patients, 416 HCCs) between January 2016 and March 2020. Results Median ablation time was significantly shorter for MTA (240 seconds) than for RFA (721 seconds; P<0.001). A significant difference in 3-year local tumor progression rate was evident between the RFA group (22%) and MTA group (8%; P<0.001). Multivariable analysis revealed ablation procedure and tumor diameter as independent factors contributing to local tumor progression (MTA; P<0.001; hazard ratio, 0.565; 95% confidence interval, 0.437–0.731). In patients with primary HCC, a significant difference in overall survival was evident (RFA vs. MTA, 3-year, 77% vs. 95%, P=0.029). Ablation procedure and Child-Pugh score were independent factors contributing to survival. The total complication rate was significantly lower for MTA (8%) than for RFA (14%, P<0.05), particularly for bile duct injury (3% vs. 9%, respectively; P<0.05). Conclusions Next-generation MTA for small HCC could provide safer, more curative treatment in a shorter ablation time than RFA.
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spelling doaj.art-a696891bdfe5410b9c560923b5c7e2362022-12-21T20:15:39ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2021-10-0127456457410.3350/cmh.2021.01361627New next-generation microwave thermosphere ablation for small hepatocellular carcinomaHideyuki TamaiJumpei Okamura0 Department of Hepatology, Wakayama Rosai Hospital, Wakayama, JapanBackground/Aims In July 2017, the Emprint™ next-generation microwave ablation system using thermosphere technology (Covidien, Boulder, CO, USA) was approved for use in Japan. This system can produce a predictable spherical ablation zone at higher temperatures than radiofrequency ablation (RFA). The aim of the present study was to elucidate whether this new microwave thermosphere ablation (MTA) could safely improve outcome compared to RFA, which is the standard of care for small hepatocellular carcinoma (HCC). Methods This retrospective study analyzed 513 patients with 630 HCCs (≤3 cm) who were performed by percutaneous RFA (174 patients, 214 HCCs) or MTA (339 patients, 416 HCCs) between January 2016 and March 2020. Results Median ablation time was significantly shorter for MTA (240 seconds) than for RFA (721 seconds; P<0.001). A significant difference in 3-year local tumor progression rate was evident between the RFA group (22%) and MTA group (8%; P<0.001). Multivariable analysis revealed ablation procedure and tumor diameter as independent factors contributing to local tumor progression (MTA; P<0.001; hazard ratio, 0.565; 95% confidence interval, 0.437–0.731). In patients with primary HCC, a significant difference in overall survival was evident (RFA vs. MTA, 3-year, 77% vs. 95%, P=0.029). Ablation procedure and Child-Pugh score were independent factors contributing to survival. The total complication rate was significantly lower for MTA (8%) than for RFA (14%, P<0.05), particularly for bile duct injury (3% vs. 9%, respectively; P<0.05). Conclusions Next-generation MTA for small HCC could provide safer, more curative treatment in a shorter ablation time than RFA.http://e-cmh.org/upload/pdf/cmh-2021-0136.pdfcarcinoma, hepatocellularradiofrequency ablationmicrowaves
spellingShingle Hideyuki Tamai
Jumpei Okamura
New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
Clinical and Molecular Hepatology
carcinoma, hepatocellular
radiofrequency ablation
microwaves
title New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
title_full New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
title_fullStr New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
title_full_unstemmed New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
title_short New next-generation microwave thermosphere ablation for small hepatocellular carcinoma
title_sort new next generation microwave thermosphere ablation for small hepatocellular carcinoma
topic carcinoma, hepatocellular
radiofrequency ablation
microwaves
url http://e-cmh.org/upload/pdf/cmh-2021-0136.pdf
work_keys_str_mv AT hideyukitamai newnextgenerationmicrowavethermosphereablationforsmallhepatocellularcarcinoma
AT jumpeiokamura newnextgenerationmicrowavethermosphereablationforsmallhepatocellularcarcinoma