Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

Abstract

Microwave ablation has increasingly been used as an alternative to radiofrequency ablation for the treatment of tumors. We performed a retrospective single center evaluation of 368 microwave ablations of liver tumors in 192 patients (36 female, 156 male, mean age 63 years) to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies. 119 ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients. The primary efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88 % vs. 76 %; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation. In addition to a small tumor size, robotic navigation is a major positive prognostic factor for primary efficacy.

Jan Schaible1, Benedikt Pregler1, Niklas Verloh1, Ingo Einspieler1, Wolf Bäumler1, Florian Zeman2, Andreas Schreyer3, Christian Stroszczynski1, Lukas Beyer1