Comparison of the efficacy of ultrasound-guided microwave ablation and laparoscopic liver resection in the treatment of elderly patients with primary liver cancer
CHEN Kaige
WANG Gongzheng
QI Xuemei
ZHAO Xinya
LIU Cuihong
Abstract：Objective To compare the efficacy of ultrasound-guided microwave ablation(MWA)and laparoscopic liver re-section(LLR)in the treatment of elderly patients with primary liver cancer.Methods A total of 220 elderly patients with pri-mary liver cancer were selected,and patients were categorized into 88 in the MWA group and 132 in the LLR group according to the treatment modality.To minimize the effect of selection bias and confounders,we performed propensity score matching on the clinical baseline profile data and finally included 64 in the MWA group and 64 in the LLR group for analysis.Long-term survival outcomes,incidence of postoperative complications,and cost of treatment time were compared between the two groups,and the overall survival and disease-free survival were expressed by Kaplan-Meier curves.Cox proportional hazards model was used to analyze the prognostic risk factors associated with the prognosis of elderly primary liver cancer.Results Compared with LLR group,MWA group had shorter operation duration,shorter postoperative hospital stay,less intraoperative blood loss,and lower complication rates(all P<0.001).The 1-,3-,and 5-year overall survival rates were 95.2%,76.4%,and 54.9%in the MWA group,and 88.9%,75.6%,and 47.4%in the LLR group,respectively,and the differences between the two groups were not sta-tistically significant(all P>0.05).The 1-,3-,and 5-year disease-free survival rates were 68.6%,36.4%,and 21.5%in the MWA group,and 78.0%,38.4%,and 18.0%in the LLR group,respectively,and the difference between the two groups was not statistically significant(all P>0.05).Combined ascites and internationalized standard ratio(INR)>1.2 were independent risk factors for overall survival,and INR>1.2 was an independent risk factor for disease-free survival(all P<0.05).Conclu-sion MWA has comparable long-term survival outcomes to LLR in the treatment of elderly primary liver cancer,with fewer com-plications and lower time-to-treatment costs,thereby providing a safe and effective alternative treatment option for elderly pri-mary liver cancer patients.
Keywords：Liver cancerMicrowave ablationLaparoscopic liver resectionLong-term survival outcomesPostoperative complications
Publication Date：2025-05-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 72-76,94 )