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Objectives: This study aimed to evaluate the feasibility, local efficacy and long-term outcomes of microwave (MW) ablation for the treatment of hepatocellular carcinoma (HCC) that met up-to-seven criteria.Methods: Between January 2007 and January 2012, 142 HCC patients with 294 nodules, which conformed to up-to-seven criteria, were enrolled into this retrospective study. All patients were followed up for more than 3 years after receiving MW ablation. Technical success, complications, local tumour progression (LTP) and distant recurrence (DR) were monitored. Recurrence-free survival (RFS), overall survival (OS) and prognostic factors were analysed.Results: Primary technical efficacy was achieved in 95.2% (280/294) of the carcinomatous nodules, and major complications occurred in four (2.8%) patients. Among the 294 tumours, LTP was observed in 44 (15.0%) tumours. Among the 142 patients, DR was observed in 97 (68.3%) patients. The estimated OS rates after MW ablation at 1, 3 and 5 years were 97.2%, 75.4% and 50.6%, respectively; and the corresponding RFS rates were 76.1%, 33.1% and 19.5%, respectively.Conclusions: MW ablation is a safe and effective treatment with a high rate of primary technical efficacy for patients with HCC that met up-to-seven criteria.Key Points: • The first study expanding MW ablation to HCC category beyond Milan criteria. • The first report that used up-to-seven criteria as indications for MW ablation. • HCC of up-to-seven criteria viewed as a subgroup of BCLC stage B. • MW ablation is safe and effective for treating HCC within up-to-seven criteria. • MW ablation is preferable in treating unresectable HCC within up-to-seven criteria. [ABSTRACT FROM AUTHOR]

Objective:This study aims to evaluate the local efficacy and long-term outcomes of microwave ablation (MWA) for treating large unresectable hepatocellular carcinomas (HCCs). Methods:A total of 82 patients with 5-6 cm unresectable HCCs, who underwent a single MWA procedure during the period of January 2007 to July 2011, were retrospectively enrolled into this study. Percentages of technical success and complications of MWA and HCC local recurrence (LR) after MWA were determined. In addition, prognostic factors were screened and overall survival (OS) and recurrence-free survival (RFS) rates were estimated. Results:One-, three- and five-year OS rates in this MWA-treated cohort were 92.7, 63.4 and 41.1%, respectively; and the corresponding RFS rates were 65.9, 31.7 and 23.0%, respectively. Primary technical efficacy was 89.0% after the first round of ablation, three (3.7%) patients developed major complications, and LR rate was 20.7%. Child-Pugh classification (p < .001), tumour location (p = .049) and LR (p = .002) were independent factors associated with OS, as determined by multivariate analysis. Conclusions:MWA is safe and effective for the treatment of selected large HCCs, and provides an alternative treatment option for patients with unresectable HCCs. Furthermore, the favourable local efficacy of MWA could potentially improve long-term survival. [ABSTRACT FROM AUTHOR]