Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation.
OBJECTIVE
Percutaneous microwave coagulation therapy (PMCT) is a new therapeutic technique for the treatment of solid neoplasms that uses an energy source different from those of other interstitial therapies. We report our initial experience using PMCT to treat hepatocellular carcinomas.


METHODS
NIne hepatocellular carcinomas exceeding 3 cm in diameter in nine patients were treated with PMCT. Within 2 weeks before PMCT, all patients had been treated with transcatheter arterial embolization therapy, which had failed to produce complete necrosis of the tumors. PMCT was done under local anesthesia. A 14-gauge guiding needle was inserted percutaneously toward the lesion under sonographic guidance, and a needle electrode was positioned precisely within the lesion. Microwaves of 2450 MHz in frequency were produced for 60 sec with a 60-W emission. Three to 12 microwave emissions were administered in each case.


RESULTS
Dynamic CT showed that unenhanced areas indicative of coagulation necrosis developed in all lesions. All lesions appeared smaller without enhancement: on CT, the tumor diameters (mean +/- SD) were 48 +/- 13 mm before treatment and 41 +/- 13 mm 1 month after treatment. Follow-up studies showed that five lesions were controlled without any signs of recurrence. All patients tolerated the treatments well, and no serious complications occurred.


CONCLUSIONS
Our preliminary experience suggests that PMCT may be a useful alternative to other forms of interstitial therapy for the treatment of hepatocellular carcinomas.
Murakami
R
R
Department of Radiology, Kumamoto Regional Medical Center, Japan.
Yoshimatsu
S
S
Yamashita
Y
Y
Matsukawa
T
T
Takahashi
M
M
Sagara
K
K
D000368:Aged; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography