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 coagulation therapy (PMCT) and percutaneous ethanol injection therapy (PEIT) in the treatment of patients with cirrhosis and a solitary nodular hepatocellular carcinoma (HCC) < or = 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 differentiated 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-differentiated HCC treated with PMCT (70%) and PEIT (78%) were not significantly different. No difference between the patterns of recurrence was observed. Among the patients with moderately or poorly differentiated HCC, overall survival with PMCT (5-year survival rate: 78%) was significantly better than with PEIT (5-year survival rate: 35%) (P = 0.03). Nine of 22 patients with moderately or poorly differentiated HCC treated with PEIT experienced recurrence in the original target subsegment. Only 2 of 25 patients treated with PMCT had a recurrence in the same subsegment as the initial tumor.


CONCLUSIONS
PMCT may be superior to PEIT for the local control of moderately or poorly differentiated small HCC.
Seki
T
T
Third Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan.
Wakabayashi
M
M
Nakagawa
T
T
Imamura
M
M
Tamai
T
T
Nishimura
A
A
Yamashiki
N
N
Okamura
A
A
Inoue
K
K
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002423:Cause of Death; D002454:Cell Differentiation; D018572:Disease-Free Survival; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D015552:Injections, Intralesional; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D000431:Ethanol