Percutaneous Cryoablation Versus Microwave Ablation for Hepatocellular Carcinoma: Comparative Study of Safety and Oncologic Outcomes.

Purpose To compare safety and oncologic outcomes of percutaneous image-guided hepatic cryoablation and microwave ablation (MWA) for treating hepatocellular carcinoma (HCC). Materials and Methods This single center, retrospective study evaluated percutaneous image-guided cryoablation and MWA procedures in patients with HCC from December 2015 to December 2023. Adverse events (AEs) were recorded per procedure. Technical success and local tumor progression-free survival were assessed per tumor and compared after propensity score matching. Intrahepatic progression-free survival, extrahepatic progression-free survival, and overall survival were measured per patient when cryoablation or MWA was used as the initial curative-intent treatment for early-stage HCC. Survival metrics were estimated using Kaplan-Meier curves and compared using log-rank testing. Results A total of 176 ablation procedures in 123 patients with 228 HCCs enabled three cohort analyses (mean age ± SD, 69 years ± 9; 85 male). Per-procedure AE analysis of 170 procedures (69 cryoablation and 101 MWA) showed no evidence of differences in overall or major AE rates (cryoablation: overall AEs, 19%, major AEs, 1%; MWA: overall AEs, 10%, major AEs, 3%;