Microwave ablation versus transcatheter arterial embolization for large hepatic hemangiomas: clinical outcomes

Figures & data

Figure 1. The flowchart of patient inclusion.

Table 1. Baseline characteristics of patients between the two study groups.

Characteristics	TAE (n = 53)	MWA (n = 82)	p Value
Gender (male/female)	19/34	32/50	.43
Age (<60/≥60, years)	48/5	72/10	.42
Number of hemangioma
Solitary/multiple	35/18	61/21	.20
Size of major hemangioma (mean ± SD (cm))	7.1 ± 1.5	6.9 ± 1.8	.50
Location of hemangioma
Non-risk site/risk site^a	36/17	58/24	.44
Laboratory data
ALT (mean ± SD (IU/L))	23.4 ± 13.8	21.3 ± 18.2	.47
AST (mean ± SD (IU/L))	21.6 ± 7.5	20.2 ± 10.6	.41
TB (mean ± SD (μmol/L))	11.5 ± 3.6	10.8 ± 4.7	.36
Creatinine (mean ± SD (μmol/L))	59.1 ± 14.7	60.8 ± 16.2	.54
Reasons for treatment			.39
Abdominal pain or discomfort	20	34
Enlargement of hemangioma	27	38
Both	6	10

TAE: transcatheter arterial embolization; MWA: microwave ablation; ALT: alanine transaminase; AST: aspartate aminotransferase; TB: total bilirubin.

^a Tumors in risk site refer to those located within 5 mm of diaphragmatic dome, large vessels or cavity viscera.

Table 2. Perioperative data between two groups.

	TAE (n = 53)	MWA (n = 82)	p Value
Operation time (mean ± SD (min))	38.2 ± 16.5	32.2 ± 21.4	.09
ALT (mean ± SD (IU/L))
Postoperative day 1	135.3 ± 283.5	273.5 ± 162.7	<.001
Postoperative day 7	37.2 ± 28.4	39.5 ± 32.7	.68
AST (mean ± SD (IU/L))
Postoperative day 1	158.7 ± 308.9	404.8 ± 256.4	<.001
Postoperative day 7	33.4 ± 21.9	36.8 ± 27.6	.45
TB (mean ± SD (μmol/L))
Postoperative day 1	28.2 ± 16.8	31.2 ± 13.5	.25
Postoperative day 7	14.6 ± 5.7	15.2 ± 6.3	.58
Time of analgesic use (mean ± SD (d))	1.4 ± 1.6	0.6 ± 0.8	<.001
Hospital cost (USD)	2517.2 ± 673.6	3758.4 ± 432.5	<.001
Hospital stay (mean ± SD (d))	5.4 ± 2.1	4.4 ± 1.7	.003

ALT: alanine transaminase; AST: aspartate aminotransferase; TB: total bilirubin; USD: United States dollar.

Figure 2. Pre-MWA (a) and one-year post-MWA and (b) CT examinations show a significant reduction in size of hemangioma after MWA treatment.

Figure 3. Pre-TAE (a) and one-year post-TAE and (b) CT examinations show a significant reduction in size of hemangioma after TAE treatment.

Table 3. Postoperative follow-up outcomes.

Treatment outcomes	TAE	MWA	p Value
Radiologic response			<.001
Complete response	20/53 (37.7%)	73/82 (89.0%)
Incomplete response	33/53 (62.3%)	9/82 (11.0%)
Clinical response
Complete response	18/26 (69.2%)	39/44 (88.6%)	.14
(Disappearance of symptoms)
Incomplete response	6/26 (23.1%)	5/44 (11.4%)	.046
(Improvement of symptoms)
None response	2/26 (7.7%)	0/44 (0%)	.17
(Persistent symptoms)

TAE: transcatheter arterial embolization; MWA: microwave ablation.

Table 4. Complications after treatment.

	TAE (n = 53)	MWA (n = 82)	SIR classification	p Value
Major complications	6 (11.3%)	8 (9.8%)		.49
Diaphragmatic hernia	0	1	D
Symptomatic pleural effusion	0	2	C
Hepatic abscess	1	0	D
Ischemic cholecystitis	2	0	D
Jaundice^a	3	2	C
Acute renal dysfunction^b	0	3	C
Minor complications	35 (66.0%)	36 (43.9%)		.019
Fever^c	7	5	B
Abdominal pain^d	14	18	B
Both fever and pain	9	5	B
Other discomfort	5	8	A

SIR: Society of Interventional Radiology; A and B: minor complications; C, D, E and F: major complications.

^a Total bilirubin ≥51.3 μmol/L.

^b Creatinine ≥200 μmol/L.

^c Fever ≥38 °C.

^d Abdominal pain: need analgesic.