Thermal ablation therapy for hepatocellular carcinoma: comparison between radiofrequency ablation and percutaneous microwave coagulation therapy.
OBJECTIVE
To evaluate the initial therapeutic effect and safety of radiofrequency ablation (RFA) and percutaneous microwave coagulation therapy (PMCT) for the treatment of small hepatocellular carcinomas (HCCs).


METHODS
Forty-eight patients with HCC were treated by RFA and 70 patients with HCC were treated by PMCT. These procedures were repeated until complete tumor necrosis was confirmed by contrast CT scanning. The therapeutic and adverse effects were compared between the two procedures.


RESULTS
1) The number of treatment sessions was significantly lower in RFA patients, and the necrotic area was significantly larger. 2) The local recurrence rate was significantly lower after RFA than after PMCT, while the ectopic recurrence rate showed no significant difference between the two procedures. 3) The survival rate was significantly higher after RFA compared with PMCT. 4) The incidence of pain and fever after treatment was significantly higher in PMCT patients. Occurrence of bile duct injury, pleural effusion and ascites were also significantly more common in PMCT patients.


CONCLUSIONS
RFA is more useful for the treatment of small HCCs compared with PMCT because it is minimally invasive and achieves a low local recurrence rate, a high survival rate, and extensive necrosis after only a few treatment sessions.
Ohmoto
Kenji
K
Division of Hepatology, Department of Medicine, Kawasaki Medical School, Okayama, Japan. ohmotok@med.kawasaki-m.ac.jp
Yoshioka
Naoko
N
Tomiyama
Yasuyuki
Y
Shibata
Norikuni
N
Kawase
Tomoya
T
Yoshida
Koji
K
Kuboki
Makoto
M
Yamamoto
Shinichiro
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D003972:Diathermy; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged