Subcapsular hepatocellular carcinoma (HCC) has unique anatomical characteristics that may influence treatment selection and clinical outcomes. Surgical resection and liver transplantation are potentially curative treatments but may be limited by liver function, tumor characteristics, and perioperative risks. Microwave ablation has become an important minimally invasive treatment option for patients with HCC, particularly for lesions that are difficult to treat surgically. This prospective observational cohort study aims to compare the therapeutic efficacy, safety, and long-term outcomes of no-touch microwave ablation, tumor-puncture microwave ablation and surgical resection in patients with subcapsular HCC. Treatment outcomes, including local tumor control, treatment-related complications, recurrence, and survival outcomes, will be evaluated to provide evidence for individualized treatment strategies for patients with subcapsular HCC.
Inclusion Criteria:
Diagnosed with hepatocellular carcinoma (HCC) confirmed by pathological biopsy or clinical diagnostic criteria; Imaging examinations including ultrasound confirm that the HCC lesion is subcapsular, defined as the minimum distance between the tumor and liver capsule ≤ 3 mm; Single tumor with maximum diameter ≤ 5 cm, or up to 3 multiple tumors each with maximum diameter ≤ 3 cm; Liver function classified as Child-Pugh grade A or B; No invasion of adjacent blood vessels or vital organs; no tumor thrombus in the main portal vein or hepatic vein, and no extrahepatic metastasis.
- Exclusion Criteria:Patients with dysfunction of vital organs such as heart and lungs; Patients who received preoperative radiotherapy, chemotherapy, targeted therapy or immunotherapy, or patients complicated with other malignant tumors; Poor follow-up compliance and inability to complete the standardized follow-up procedures.
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dezhi@jlu.edu.cn
Eligible patients meeting the inclusion criteria, including those with subcapsular hepatocellular carcinoma within Milan criteria, who receive ultrasound-guided percutaneous non-contact microwave ablation as part of routine clinical practice will be included in this cohort. In this treatment modality, the ablation antenna is positioned in the normal liver parenchyma surrounding the tumor rather than directly puncturing the lesion. Tumor inactivation is achieved through microwave thermal radiation. Clinical outcomes, including local tumor control, recurrence, treatment-related complications, and survival outcomes, will be evaluated during follow-up.
Patients with subcapsular hepatocellular carcinoma who meet the inclusion criteria and receive conventional ultrasound-guided percutaneous contact microwave ablation with direct tumor puncture as part of routine clinical practice will be included in this cohort. In this treatment modality, the microwave ablation antenna is directly inserted into the tumor under ultrasound guidance, and tumor necrosis is achieved through microwave thermal effects. During the study period, patients will be followed up to evaluate local tumor control, recurrence, treatment-related complications, and survival outcomes.
Patients with subcapsular hepatocellular carcinoma who undergo surgical resection as part of routine clinical practice will be included in this cohort. The hepatobiliary surgery team will select open or laparoscopic surgical approaches based on tumor characteristics, hepatic functional reserve, and individual patient conditions. Surgical treatment aims to achieve complete tumor removal while preserving normal liver tissue as much as possible and minimizing surgical trauma. During the study period, patients will be followed up to evaluate local tumor control, recurrence, treatment-related complications, and survival outcomes.
To Compare the Efficacy of Microwave Ablation and Laparoscopic Hepatectomy for Hepatocellular Carcinoma
Microwave Ablation Versus Laparoscopic Hepatectomy for 3-5cm Hepatocellular Carcinoma
Effectiveness of Microwave Ablation of Hepatocellular Carcinoma as Compared to Radiofrequency Ablation
Microwave Ablation Versus Liver Resection For Early Hepatocellular Carcinoma in Patients With Borderline Liver Function
Radiofrequency Ablation Using Combined RF Energy Delivery Mode and Octopus Electrodes for Hepatocellular Carcinoma
"No-Touch" Radiofrequency Ablation for Small Hepatocellular Carcinoma (≤ 3cm): A Prospective Multicenter Study