Efficacy analysis of ultrasound-guided percutaneous hepatic microwave ablation for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) remains a major global health challenge, particularly in regions with high rates of chronic liver disease. This study evaluates the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0–A HCC. A prospective single-center cohort design was employed, and after propensity score matching, patients undergoing MWA were compared to those receiving surgical resection or radiofrequency ablation (RFA). Key endpoints included perioperative outcomes, disease-free survival (DFS), overall survival (OS), and local recurrence rates. Results showed that the MWA group had significantly shorter hospital stays and less liver function impairment postoperatively, with comparable complication rates to the control group. There were no statistically significant differences between the two groups in 1-year DFS, local recurrence, or 3-year OS. Multivariate analysis identified tumor size >3 cm as an independent risk factor for poorer survival, while achieving a safety margin ≥5 mm was protective. These findings suggest that MWA is a minimally invasive, safe, and effective alternative to surgery or RFA for small HCCs in well-selected patients, offering comparable oncologic outcomes with improved perioperative safety. The study supports the expanded use of MWA as a front-line local therapy for early-stage liver cancer.