Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma

BACKGROUND, Compared with other treatments, microwave coagulation is a rela tively less invasive treatment for Various kinds of solid tumors. Although its effectiveness in primary hepatocellular carcinoma has been shown. its e ffectiveness in the treatment of hepatic metastases from colorectal carcino ma has been unclear. The aim of this study was to evaluate its effectivenes s in the treatment of multiple hepatic metastases from colorectal carcinoma by comparing this technique with that of hepatic resection. METHODS, Thirty patients with multiple metastatic colorectal tumors in the liver who were potentially amenable to hepatic resection were randomly assi gned to treatment with microwave coagulation (14 patients) or hepatectomy ( 16 patients). Tumors in the microwave group were coagulated after laparotom y at an output of 60-100 W for 2-20 minutes under the guide of ultrasonogra phy, whereas tumors in the hepatectomy group were treated with lobectomy, s egmentectomy, subsegmentectomy, and/or wedge resection. RESULTS. One-, 2-, and 3-year survival rates and mean survival times were 7 1%, 57%, 14%, and 27 months, respectively, in the microwave group. whereas they were 69%, 56%, 23%, and 25 months, respectively, in the hepatectomy gr oup. The difference between these two groups was statistically not signific ant (P = 0.83). On the other hand, the amount of intraoperative blood loss in the microwave group (360 +/- 230 mL) was smaller than that in the hepate ctomy group (910 +/- 490 mt, P < 0.05). Blood transfusion was necessary for 6 patients in the hepatectomy group, but it was not necessary in the micro wave group. CONCLUSIONS, Microwave coagulation therapy is suggested to be equally effec tive as hepatic resection in the treatment of multiple (two to nine) hepati c metastases from colorectal carcinoma, whereas its surgical invasiveness i s less than that of hepatic resection. (C) 2000 American Cancer Society.