微波消融在肝脏肿瘤的治疗中变得越来越普遍。尽管有大量研究旨在确定微波消融后局部复发的危险因素，但关于可改变的失败危险因素的共识仍然难以达成，部分原因是这些研究的统计能力有限。本研究调查了微波消融后技术失败的发生率，包括不完全消融和局部复发，旨在确定减少技术失败的可修改因素。这项回顾性审查包括 2006 年 10 月期间在一家大容量机构接受外科微波消融的患者和 2023 年 3 月。通过单变量分析、多变量分析和倾向评分匹配来确定技术失败的风险因素。对 3,035 个肿瘤总共进行了 1,613 次微波消融手术，其中 226 例（每次手术 14%，每个肿瘤 7.4%） ）的技术故障。每个肿瘤的不完全消融发生率为 1.7%，而在每个肿瘤分析中，6.5% 的消融发生局部复发。体重指数>25对于失败具有显着性（比值比，1.50；95%置信区间，1.07-2.11；P < .05），表明更困难的靶向可能导致技术失败率增加。非裔美国人种族（比值比，1.62；95% 置信区间，1.16-2.27；P < .05），微波消融前经动脉化疗栓塞术（比值比，1.54；95% 置信区间，1.08-2.21；P < .05）和之前的消融（比值比，1.58；95% 置信区间，1.09-2.29；P < .05）被发现具有统计显着性。在迄今为止最大的微波消融数据库的基础上，本研究确定了新颖的可修改和微波消融失败的不可改变的危险因素。这些结果可以降低微波消融后的技术故障率。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Microwave ablation is becoming increasingly common for the treatment of liver tumors. Despite numerous studies aimed at identifying risk factors for local recurrence after microwave ablation, a consensus on modifiable risk factors for failure remains elusive, partly because of the limited statistical power of these studies. This study investigated the incidence of technical failure after microwave ablation, encompassing both incomplete ablation and local recurrence, and aimed to identify modifiable factors that reduce technical failure.This retrospective review included patients who underwent surgical microwave ablation at a high-volume institution between October 2006 and March 2023. Univariate analysis, multivariate analysis, and propensity score matching were performed to identify risk factors for technical failure.A total of 1,613 surgical microwave ablations were performed on 3,035 tumors, with 226 instances (14% per procedure, 7.4% per tumor) of technical failure. Incomplete ablation occurred at a rate of 1.7% per tumor, whereas local recurrence was identified in 6.5% of ablations in per-tumor analysis. Body mass index >25 was significant for failure (odds ratio, 1.50; 95% confidence interval, 1.07-2.11; P < .05), suggesting that more difficult targeting may lead to increased technical failure rates. African American race (odds ratio, 1.62; 95% confidence interval, 1.16-2.27; P < .05), pre-microwave ablation transarterial chemoembolization (odds ratio, 1.54; 95% confidence interval, 1.08-2.21; P < .05), and previous ablation (odds ratio, 1.58; 95% confidence interval, 1.09-2.29; P < .05) were found to be statistically significant.On the basis of the largest microwave ablation database available to date, this study identified novel modifiable and nonmodifiable risk factors of microwave ablation failure. These results can lead to decreasing technical failure rates after microwave ablation.Copyright © 2024 Elsevier Inc. All rights reserved.