| Objective: To explore the effect of intrahepatic vessels(> 3mm)on efficacy of microwave ablation(MWA)for hepatocellular carcinoma(HCC)adjacent to vessels.Materials and Methods: From January 2015 to December 2018,126 patients with HCC(a total of 199 tumors)underwent MWA in our department.According to the location of the tumor in the liver,the tumors completely adjacent to the hepatic veins,portal veins,or vena cava vessels > 3mm were defined as the adjacent vascular group.A total of 37 patients with 40 tumors were included.Tumors more than 10 mm from hepatic veins,portal veins,or vena cava lesions with a distance of > 3mm were defined as non-adjacent vascular group,and a total of 89 patients with 159 tumors were included.To avoid interference from other factors,tumors within 5 mm from the liver capsule,gallbladder,and gastrointestinal tract were excluded.Considering the heterogeneity of tumors two groups,the 1: 2 propensity score matching(PSM)was used to balance selectivity bias and confounding effects in both groups.The primary technique efficacy rate,local tumor progression rate(LTP)and complications after MWA were analyzed and compared.Results: 40 tumors in the adjacent vascular group and 80 tumors in the non-adjacent vascular group were successfully matched and included in the analysis.The total primary technique efficacy rate was 86.7%(104/120),and it was 87.8% in adjacent vascular group and 86.2% in non-adjacent vascular group(P = 0.849).Multivariate analysis suggested that adjacent vessels had no significant effect on the primary technique efficacy rate(OR = 0.907,95% CI = 0.258-3.192,P = 0.693).With a median follow-up of 14 months,the overall LTP rate was 23.1%(24/104).The 1-and 2-year LTP rates of the adjacent and non-adjacent vascular group were 8.0%,27.0% and 9.0%,31.0%,respectively.Multivariate analysis showed no significant difference in LTP rate between these two groups(HR = 0.874,95% CI = 0.363-2.108,P = 0.765).There were also no significant differences in complications between these two groups(P = 0.492).Conclusion: MWA for adjacent or non-adjacent intravascular liver lesions,there is no significant difference in technique efficacy rate and local progression rate.Intrahepatic blood vessels(> 3mm)had no significant effect on the efficacy of MWA in the treatment of hepatocellular carcinoma,and did not show a significant heat-sink effect. |
