Value of laparoscopic microwave coagulation therapy for hepatocellular carcinoma in relation to tumor size and location

Background and Study Aims: The indications for laparoscopic microwave coagu lation therapy (LMCT) for hepatocellular fat-cinema (HCC) have not yet been adequately evaluated, This study investigated the value of LMCT in the tre atment of HCC. Patients and Methods: Forty-three patients with liver cirrhosis (including five patients in Child Pugh grade C), with 56 HCC lesions, were enrolled in the study, When dynamic computed tomography (CT) showed a loss in HCC enha ncement characteristics and a low concentration area after LMCT, a lesion w as judged to have undergone complete necrosis. Results: The rate of complete necrosis for lesions measuring 40 mm or less was significantly higher (P<0.01) than for those measuring 41 mm or more. T he rate of complete necrosis for lesions located on the liver surface, excl uding those located close to the gallbladder or in contact with the diaphra gm, was also significantly higher (P<0.01) than for those situated deep wit hin the liver. The outcome for lesions of 40 mm or less was favorable. Intr a-abdominal hemorrhage occurred in two patients, pneumothorax in three, and hepatic infarction in one, all associated with LMCT. However, these patien ts did not suffer any sequelae of clinical significance. Conclusions: This study suggests that there is a strong indication for LMCT for HCCs measuring 40 mm or less in diameter and those located on the live r surface even if they are as large as 50 mm, but not for those located dos e to the gallbladder or in contact with the diaphragm, LMCT appears to be a pplicable in patients with impaired liver function.