Efficacy and Safety of Microwave Ablation in Patients With Hepatocellular Carcinoma With Decompensated Liver Cirrhosis: A Retrospective Study.

Objective: Except for liver transplantation, no definitive treatment exists for hepatocellular carcinoma (HCC) in individuals suffering from decompensated liver cirrhosis. This research evaluated the feasibility and outcomes of microwave ablation (MWA) treatment in this patient population. Methods: This research involved individuals diagnosed with HCC and decompensated cirrhosis who underwent MWA between 2019 and 2022. The analysis examined complications associated with the procedure, the effectiveness of treatment, patient survival rates, and the variations in blood test results and liver function reserves before and after MWA. Results: The 62 enrolled patients were predominantly male (n = 48), and the average age was 59.06 years. Fifty-one patients were diagnosed with HBV-related cirrhosis. The tumor characteristics varied: 47 patients had single lesions with diameters ranging from 8 to 57 mm. Following the MWA procedure, there was a notable rise in the levels of alanine transaminase, aspartate transaminase, total bilirubin, prothrombin time, and the Child-Pugh, albumin-bilirubin, and model for end-stage liver disease scores (p < 0.05). Analysis of survival data indicated that tumor diameter < 3 cm, complete response (CR), meeting the Milan criteria, and Barcelona Clinic Liver Cancer (BCLC) Stage 0-A were linked to a more favorable prognosis. Multivariable Cox regression analysis identified achieving a CR as the strongest independent predictor for improved overall survival (HR = 0.25, 95% CI [0.09, 0.66], p = 0.005). Furthermore, the Milan criteria were independently associated with reduced risk of tumor progression in both univariate and multivariate analyses. Conclusion: MWA is a safe procedure for individuals with HCC and decompensated liver cirrhosis. CR is associated with a better prognosis.