Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study

Objective The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).Methods This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as...

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Main Authors: Qian Cai, Tong-Gang Qian, Qi-Yu Zhao, Shun-You Feng, Qiao Yang, Yan-Chun Luo, Yu-Qing Dai, Ping Liang, Xiao-ling Yu, Fang-Yi Liu, Zhi-Yu Han, Qiao-Wei Du, Xin Li, Jie Yu
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:International Journal of Hyperthermia
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Online Access:https://www.tandfonline.com/doi/10.1080/02656736.2023.2285705
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Summary:Objective The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).Methods This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR.Results During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion’s heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006).Conclusions Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.
ISSN:0265-6736
1464-5157