Microwave Ablation Versus Liver Resection For Early Hepatocellular Carcinoma in Patients With Borderline Liver Function

  • STATUS
    Recruiting
  • End date
    Jul 11, 2025
  • participants needed
    76
  • sponsor
    Chinese University of Hong Kong
Updated on 11 August 2021
metastasis
hepatectomy

Summary

We propose a randomized controlled study to compare the treatment efficacy of microwave ablation to liver resection for hepatocellular carcinoma (HCC) in patients with borderline liver function.

Description

Hepatocellular carcinoma (HCC) is a common cancer and is diagnosed at an earlier stage and with increasing frequency because of the wider implementation of screening programs. Whether liver resection or local ablation should be the first-line treatment in early HCC remains a hot topic for debate. Both are regarded as acceptable curative treatment for early HCC in many international guidelines. Underlying liver function is the key in treatment selection. The general consensus is that liver resection should be the treatment of choice in patients with good liver function while local ablation should be considered in patients with poor liver function. There exists a group of patients with apparently good liver function that harbor significant liver cirrhosis which is not easily picked up by the current assessment or scoring systems. Liver resection in this group of patients is burdened by potentially life-threatening complications and the overall survival is limited by their underlying liver cirrhosis. This is particularly important in early HCC as local ablation is another curative treatment option. In order to improve the prognosis of patients with early HCC, it is important to identify (1) patients with liver dysfunction to the extend that the risk of liver resection will outweigh the survival benefit it provides; (2) the best ablative method for HCC.

The investigators propose to carry out a prospective randomized controlled study to compare the treatment outcome of microwave ablation with liver resection in patients with borderline liver function whose HCC that are amendable to both liver resection and microwave ablation.

Details
Condition liver cell carcinoma, HEPATOCELLULAR CARCINOMA
Treatment Microwave Ablation, Liver Resection
Clinical Study IdentifierNCT03766555
SponsorChinese University of Hong Kong
Last Modified on11 August 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Age >18 years
HCC amendable for both MWA and liver resection
Liver function of ALBI Grade 2
Tumour size </= 5cm
Absence of extrahepatic metastasis
Absence of radiology evidence of major vascular or bile duct invasion

Exclusion Criteria

Informed consent not available
Patients with ALBI 3, Child-Pugh B or above
Multifocal tumour
Presence of portal vein or hepatic artery thrombosis
Anticipation of concomitant procedures
Emergency hepatectomy
Ruptured HCC
Patients with chronic renal failure
Pregnant female patients
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