MICROWAVE COAGULATION THERAPY FOR HEPATOCELLULAR-CARCINOMA

Background & Aims: Surgical resection is not always feasible in patien ts with hepatocellular carcinoma. Microwave coagulation therapy has be en used as an alternative to resection, and its efficacy has been eval uated. Methods: Nineteen patients with unresectable hepatocellular car cinoma underwent microwave coagulation therapy through laparotomy (n = 12), laparoscopy (n = 5), or thoracotomy (n = 2) because of advanced liver cirrhosis and/or intrahepatic metastases. One nodule was treated in 13 patients, and two to five nodules were treated in 6 patients; t umor size ranged from 5 to 90 mm. Patient outcomes were studied. Resul ts: Microwave coagulation therapy created a reproducible regional necr osis. Fourteen patients underwent potentially curative treatment; the remaining 5 patients underwent palliative treatment (n = 4) or incompl ete tumor coagulation (n = 1). Of the 31 nodules treated, 28 underwent complete tumor ablation. Only 2 patients undergoing laparoscopic micr owave coagulation therapy developed local recurrence. The coagulated a rea subsequently shrank. Patients showed rapid recovery without hepati c dysfunction. Thirteen patients, including 2 long-term survivors, are alive either without tumor (n = 10; 14-64 months) or with tumor (n = 3; 17-22 months). Six patients died of hepatocellular carcinoma (n = 4 ) or liver insufficiency (n = 2). Conclusions: This preliminary study suggests the efficacy of microwave coagulation therapy, including safe ty and potential curability, in patients with hepatocellular carcinoma with advanced liver cirrhosis and multifocal or central tumors.