Abstract: Objective: To evaluate the efficacy, safety and application value of microwave ablation for patients with liver cancer associated with hepatitis B and lung metastases in the era of pre-target immunotherapy.
Methods: From November 2010 to December 2014,30 patients (24 males and 6 females) with pulmonary metastases were treated by microwave ablation Age ranged from 35 to 74 years, with a median age of 57.1 years. 67 pulmonary metastases were detected by chest CT and 67 lesions were ablated. The diameter of the tumor ranged from 0.5 cm to 4.1 cm in 9 patients with single lesion, 5 patients with 2 lesions and 16 patients with 3 lesions, the average diameter was 1.37 cm. Kaplan-meier method was used to calculate local tumor control rate, median survival time and complications.
Results: Microwave ablation was successfully performed 46 times in 67 cases of liver cancer with lung metastases. One to three months after ablation, enhanced CT showed no enhancement in the target area. The complete ablation rate was 100% , and the median survival time was 27.5 months, the main complications included local pain (6 cases) , paroxysmal cough (13 cases) and a small amount of hemoptysis (3 cases) , 10 patients developed mild pneumothorax without special treatment, and 3 patients developed moderate to severe pneumothorax. Immediate closed chest drainage was performed.
Conclusion: CT-guided microwave ablation is a safe and effective method for the treatment of lung metastases from hepatitis B-related liver cancer.

Key words: Hepatitis B-related hepatocellular carcinoma, Lung oligometastasis, Microwave ablation