Percutaneousmicrowaveablationvsradiofrequencyablationinthetreatmentofhepatocellularcarcinoma

摘要： Hepatocellularcancerranksfifthamongcancersandisrelatedtochronicviralhepatitis,alcoholabuse,steatohepatitisandliverautoimmunity.Surgicalresectionandorthotopiclivertransplantationhavecurativepotential,butfewerthan20%ofpatientsaresuitablecandidates.Interventionaltreatmentsareofferedtothevastmajorityofpatients.Radiofrequency(RFA)andmicrowaveablation(MWA)areamongthetherapeuticmodalities,withsimilarindicationswhichincludethepresenceofuptothreelesions,smallerthan3cminsize,andtheabsenceofextrahepaticdisease.Thetherapeuticeffectofbothmethodsreliesonthermalinjury,butMWAusesanelectromagneticfieldasopposedtoelectricalcurrentusedinRFA.UnlikeMWA,theeffectofRFAispartiallylimitedbytheheat-sinkeffectandincreasedimpedanceoftheablatedtissue.ComparedwithRFA,MWAattainsamorepredictableablationzone,permitssimultaneoustreatmentofmultiplelesions,andachieveslargercoagulationvolumesinashorterproceduraltime.Majorcomplicationsofbothmethodsarecomparableandinfrequent(approximately2%-3%),andtheyincludehaemorrhage,infection/abscess,visceralorganinjury,liverfailure,andpneumothorax.RFAmayincurtheadditionalcomplicationofskinburns.Nevertheless,thereisnocompellingevidencefordifferencesinclinicaloutcomes,includinglocalrecurrenceratesandsurvival. （共10頁）