Microwave ablation versus hepatic resection in management of hepatocellular carcinoma

Background Management of early hepatocellular carcinoma (HCC) in cirrhotic patients is still a challenge. Hepatic resection remains the best curative treatment, but more complications with a risk of HCC recurrence in cirrhotic patients make it less favorable. Few studies have recently started to evaluate microwave ablation (MWA) as a method of HCC eradication in cirrhotic patient and compare it by other ablative methods. The aim of this study was to evaluate patient with HCC before and after both MWA and hepatic resection. Patients and methods A prospective study was performed in Assiut University Hospital in collaboration with National Hepatology and Tropical Medicine Research Institute in Cairo. We recruited 40 patients; all of them had radiology‑proved HCC with lesion up to 5 cm and amenable for MWA or surgical resection. Results There is a statistically significant difference between Child score after hepatic resection in comparison with the mean Child score for patients who underwent MWA (before ablation was 6.1 ± 0.7 and after ablation was 6.1 ± 1.0, but was 5.5 ± 0.6 and was 7.2 ± 1.4 after hepatic resection). There is marked decrease of α‑fetoprotein after hepatic resection (as the mean level before resection was 172.73 and after liver resection was 10.95). Fewer complications were recorded after MWA in comparison with that after hepatic resection. Conclusion Hepatic resection is superior to MWA in HCC eradication as no residual activity. MWA is better than hepatic resection in maintaining the Child score, as it was more affected in patients who underwent hepatic resection than those who underwent MWA.