CT Guided Microwave Ablation for Hepatocellular Carcinomas: Outcomes From a Tertiary Australian Centre

INTRODUCTION: CT guided microwave ablation (MWA) provides a suitable nonsurgical alternative for the treatment of hepatocellular carcinomas (HCC) in order to improve overall survival and local tumour progression. The purpose of this retrospective audit was to evaluate the overall efficacy of MWA and provide local data into the treatment's success, recurrence rates and overall survival. METHODS: A retrospective single centre audit of MWA for Hepatocellular Carcinomas (HCC) undertaken by interventional radiology at a large tertiary centre identified 90 eligible participants between January 2019 and 31st August 2024. Analysis among participants evaluated the overall technical success, procedural morbidity and mortality, and oncological outcomes including overall survival and local tumour progression through descriptive statistics. RESULTS: Of the 89 included participants (90 ablated HCCs), there was no reported immediate post-procedure residual disease with a peri-procedure morbidity of 5.6%, with all reported procedural complications minor. Median recurrence-free survival was 26.5 months (IQR 8.25-39.75 months) with a median time to local tumour progression of 12 months (IQR 8.5-48.1 months). The overall local tumour progression rate was 13.3%. The overall survival at one year was 88.89% (n = 63) and two years of 72.92% (n = 48). The median survival time was 35 months (95% CI 30-42 months). CONCLUSION: MWA provides an effective and feasible nonsurgical treatment option for solitary HCCs with reported local tumour progression, overall survival, and technical success consistent with internationally published literature.