Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma.
BACKGROUND
Compared with other treatments, microwave coagulation is a relatively less invasive treatment for various kinds of solid tumors. Although its effectiveness in primary hepatocellular carcinoma has been shown, its effectiveness in the treatment of hepatic metastases from colorectal carcinoma has been unclear. The aim of this study was to evaluate its effectiveness 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 assigned to treatment with microwave coagulation (14 patients) or hepatectomy (16 patients). Tumors in the microwave group were coagulated after laparotomy at an output of 60-100 W for 2-20 minutes under the guide of ultrasonography, whereas tumors in the hepatectomy group were treated with lobectomy, segmentectomy, subsegmentectomy, and/or wedge resection.


RESULTS
One-, 2-, and 3-year survival rates and mean survival times were 71%, 57%, 14%, and 27 months, respectively, in the microwave group, whereas they were 69%, 56%, 23%, and 25 months, respectively, in the hepatectomy group. The difference between these two groups was statistically not significant (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 hepatectomy group (910 +/- 490 mL, P < 0.05). Blood transfusion was necessary for 6 patients in the hepatectomy group, but it was not necessary in the microwave group.


CONCLUSIONS
Microwave coagulation therapy is suggested to be equally effective as hepatic resection in the treatment of multiple (two to nine) hepatic metastases from colorectal carcinoma, whereas its surgical invasiveness is less than that of hepatic resection.
Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
T
T
Shibata
T
T
Niinobu
N
N
Ogata
M
M
Takami
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000097:blood / Q000473:pathology*; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D016019:Survival Analysis