ArticleJournal of hepatocellular carcinoma2026
Impact of Microwave Ablation on Growth Kinetics of Residual versus Synchronous Untreated Hepatocellular Carcinoma: A Retrospective Cohort Study.
Article in Journal of hepatocellular carcinoma, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: After ablation for hepatocellular carcinoma (HCC), tumors may persist as residual lesions after incomplete ablation or remain untreated in patients undergoing palliative ablation for multifocal disease. The post-ablation growth kinetics of these two lesion types have not been systematically compared. This study aimed to compare the post-ablation growth kinetics of residual and synchronous untreated HCC lesions after microwave ablation (MWA) and to identify factors associated with rapid progression. Methods: In this retrospective cohort study from September 2013 to December 2021, patients who underwent MWA and had residual lesions or synchronous untreated lesions were included. Tumor volume doubling time (TVDT) was calculated from serial MRI. Paired comparisons were used to assess changes in growth kinetics before and after ablation when longitudinal measurements were available, and a multivariable mixed-effects model was used to identify predictors of rapid growth (TVDT ≤ 3 months). Results: A total of 103 patients were included: 30 with residual lesions (30 lesions) and 73 with synchronous untreated lesions (82 lesions). Among lesions with serial imaging, synchronous untreated lesions showed a shorter TVDT after ablation than before ablation (median ΔTVDT: -3.51 months; P = 0.030), while residual lesions showed no significant change (median ΔTVDT: +0.91 months; P = 0.734). Post-ablation TVDTs did not differ significantly between the two groups (2.75 vs. 3.78 months; P = 0.997). Poor tumor differentiation (odds ratio [OR] = 10.79, 95% CI 2.07-56.33; P = 0.005) and maximum ablation lesion diameter > 3 cm (OR = 4.01, 95% CI 1.21-13.24; P = 0.023) were independently associated with rapid growth. An interaction with neutrophil-to-lymphocyte ratio was observed in exploratory subgroup analysis. Conclusion: Synchronous untreated HCC lesions appeared to show faster growth during the post-ablation period, whereas residual lesions showed no consistent change in growth kinetics. These findings may support closer post-ablation surveillance and individualized management.
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