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Hepatocellular carcinoma (HCC) is the sixth most common malignancy in the world in terms of numbers of cases (626 000 or 5.7% of new cancer cases) and causes more than 500 000 deaths every year [1]. In addition, the liver is also a common site of metastasis from invasive solid tumors, such as colon cancer, breast cancer, neuroendocrine tumors, and sarcomas. The majority of patients with hepatic malignancies are not suitable for potentially curative resection due to inadequate hepatic reserve, advanced tumor stage, or other contraindications. The rate of surgical resection has been reported to be less than 30% of primary liver cancers and 10%–20% of liver metastasis [2]. Recently, ultrasound (US)-guided percutaneous microwave ablation (MWA) as a minimally invasive therapy has been developed and has been widely used in the clinical treatment of liver cancer. Clinical evidence has confirmed the efficacy and safety of percutaneous MWA and radiofrequency ablation (RFA) for the treatment of HCC, especially for small HCCs measuring ≤ 3 cm [3–4]. However, for cases in which the tumors are adjacent to large vessels, some previous studies have defined this as a treatment contraindication because of the higher rate of complications and incomplete necrosis [5]. With the developments in technology and the accumulation of clinical experience, more studies have been published in this field. Some studies had shown that the rate of complete ablation and local tumor progression of local thermal ablation compared favorably with those far away from the large blood vessels [6–7]. Other researchers express the opinion that a lesion located in ORIGINAL ARTICLE

Ultrasound-guided percutaneous microwave ablation for small liver cancers adjacent to large vessels: long-term outcomes and strategies