title: Long-term outcomes for patients with solitary hepatocellular carcinoma treated by laparoscopic microwave coagulation.
abstract: BACKGROUND
  Although many reports on the treatment of hepatocellular carcinoma (HCC) by microwave coagulation have been published recently, none have incorporated data for the long-term therapeutic efficacy of laparoscopic microwave coagulation (LMC). In the current study, the efficacy of LMC was assessed.
  
  
  METHODS
  The authors performed LMC under local anesthesia in 69 previously untreated patients with solitary HCCs < or = 4.0 cm in greatest dimension. The maximum diameter for the tumors averaged 22.6 +/- 7.4 mm. Long-time survival rate was evaluated according to the size and histologic grade of the tumor.
  
  
  RESULTS
  The 5-year overall cumulative survival rate for the 69 patients was 63.9%. The 5-year overall survival rate for patients with well differentiated HCC was 78.9%, whereas patients with moderately or poorly differentiated HCC had a 5-year overall survival rate of 38.9%. The 5-year cumulative survival rate for patients with HCCs < or = 2.0 cm in diameter was 76.0%, and 56.3% for patients with HCCs >2.0 cm. Twelve patients (17.4%) showed local tumor recurrence during the follow-up period. Local tumor recurrence was observed in 6 of 21 patients with moderately or poorly differentiated HCCs (28.6%) and in 6 of 40 patients with well differentiated HCCs (15.0%). The 3-year cancer-free survival rate for patients with well differentiated HCC was 44.4%, whereas it was 12.2% for patients with moderately or poorly differentiated HCC.
  
  
  CONCLUSIONS
  A major factor that influenced outcome in LMC was tumor cell differentiation. LMC procedures were best suited for treatment of well differentiated HCC.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical School, Tochigi, Japan. kawamoto@saitama-med.ac.jp
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kawamoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ido
authors.forename: Norio
authors.initials: N
authors.lastname: Isoda
authors.forename: Masanori
authors.initials: M
authors.lastname: Hozumi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nagamine
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ono
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Genta
authors.initials: G
authors.lastname: Nagae
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D002454:Cell Differentiation; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography