introduction / background

In comparison to Radiofrequency ablation (RFA), Microwave ablation (MWA) has several theoretical advantages such as a broader zone of active heating, higher temperatures within the targeted area in a shorter treatment time and the lack of heat-sink effect. Despite complete ablation of the tumor, intrahepatic recurrence limits the potential therapeutic effect on HCC. Intrahepatic recurrence is a chief obstacle in HCC treatment.


The aim of this study was to detect the major risk factors for local recurrence after microwave ablation of hepatocellular carcinoma.

Materials & Methods

It is a prospective cohort study. A total of 92 patients with 110 HCC focal lesions (FLs)who were enrolled from Tropical Medicine Departments of Tanta University Hospital and Cairo university Hospital. They were subjected to detailed history taking and full clinical examination and routine laboratory investigations. They underwent MWA therapy. All the patients underwentand Abdominal ultrasound with Doppler sonography and triphasic CT before and after 1 and 3 months of MWA therapy. Complete ablation and recurrence rates were recorded, and the risk factors associated with recurrence were analyzed using SPSS. ANOVA, ANOVA (F), chi square test and Pvalue were calculated. The diagnostic accuracy was determined by receiver operator characteristic (ROC) curve analysis, reporting area under the curve (AUC) and its 95% confidence interval. The diagnostic cut off and the related sensitivity and specificity were determined.


Regarding the 110 HCC FLs that were detected pre-MWA, adequate ablation was recorded post-MWA procedure in 88 FLs (80%) and incomplete ablation in 22 FLs (showed residual contrast enhancement). However, there were newly detected lesions (17 FLs). The rate of recurrence was significantly higher in patients with multiple larger (> 4 cm) sized and hypervascular nodules. Diabetics were significantly associated with a higher recurrence rate of HCC. The rate of recurrence was significantly higher in patients with baseline level of serum alfa-fetoprotein (AFP) ≥200 ng/mL. Stiffer liver> 25 kPa had higher incidence for recurrence after ablation.


Meticulous follow-up is mandatory in diabetic patients, patients with AFP > 200 ng/dL starting value, hypervascular large hepatic FL, and in stiffer liver> 25 kPa, as these patients have higher incidence for recurrence after ablation.


[1] Ziada DH, El Sadany S, Soliman H, et al. Prevalence of hepatocellular carcinoma in chronic hepatitis C patients in Mid Delta, Egypt: A single center study. J Egypt Natl Canc Inst. 2016 Dec; 28(4):257-262. [2] Sheta E, El-Kalla F, El-Gharib M, et al. Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study.Eur J Gastroenterol Hepatol. 2016 Oct; 28(10):1198-203. [3] Xu Y, Shen Q, Wang N, et al. Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma.. Chin J Cancer. 2017 Jan 19; 36 (1):14.

acknowledgement / Contact

© 2021. Tanta University. All right reserved.