Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma - Comparison with percutaneous ethanol injection therapy

BACKGROUND. The authors compared the efficacy of percutaneous microwave coa gulation therapy (PMCT) and percutaneous ethanol injection therapy (PEIT) i n the treatment of patients with cirrhosis and a solitary nodular hepatocel lular carcinoma (HCC) less than or equal to 2 cm in greatest dimension. METHODS. Of 43 patients with well-differentiated HCC, 23 were treated with PMCT and 20 with PEIT. Of the 47 patients with moderately or poorly differe ntiated HCC, 25 were treated with PMCT and 22 with PEIT. In a retrospective , nonrandomized study, the prognoses of 90 patients during the 12-72 months preceding the study were analyzed according to histologic tumor grade. RESULTS. The overall 5-year survival rates for patients with well-different iated HCC treated with. PMCT (70%) and PEIT (78%) were not significantly di fferent. No difference between the patterns of recurrence was observed. Amo ng the patients with moderately or poorly differentiated HCC, overall survi val with PMCT (Ei-year survival rate: 78%) was significantly better than wi th PEIT (5-year survival rate: 35%) (P = 0.03). Nine of 22 patients with mo derately or poorly differentiated WCC treated with PEIT experienced recurre nce in the original target subsegment. Only 2 of 25 patients treated with P MCT had a recurrence in die same subsegment as the initial tumor. CONCLUSIONS. PMCT may be superior to PEIT for the local control of moderate ly or poorly differentiated small HCC. (C) 1999 American Cancer Society.