Percutaneous coagulation therapy of hepatocellular carcinoma by combining microwave coagulation therapy and ethanol injection.
OBJECTIVE
To determine if larger hepatocellular carcinoma (HCC) coagulation volumes can be obtained by combining percutaneous microwave coagulation therapy (PMCT) and ethanol injection (PEI) or PEI followed by PMCT with occlusion of the feeding artery.


METHODS
Eighty patients with 88 HCCs were treated with (I) PMCT; (II) combined therapy of PEI immediately followed by PMCT; (III) combined therapy of PEI immediately followed by PMCT with occlusion of the feeding artery. The coagulated area was measured at the maximum diameter perpendicular to the needle tract on enhanced computed tomography (CT) scan performed immediately after therapy. The local effect of the treatment was evaluated by enhanced CT follow-up. The rate of complete necrosis was compared in the three treatment groups.


RESULTS
The coagulation area and the rate of complete necrosis in group I was 28+/-4.6 mm and 22.5% (7/31), respectively; the coagulation area and complete necrosis in group II were 36+/-8.3 mm and 58.6% (17/29), respectively; the coagulation area and rate of complete necrosis in group III were 46+/-8.5 mm and 92.8% (26/28), respectively. The difference in the coagulation area and the rate of necrosis were significantly larger in the group II than group I (p<0.001, p<0.05), and in group III than group II (p<0.001, p<0.05).


CONCLUSIONS
Combined therapy of PEI immediately followed by PMCT, especially with occlusion of the feeding artery can significantly coagulate larger volumes of tumor and improve the rate of complete necrosis.
Zhou
Ping
P
Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha 410013, China. zhouping1000@hotmail.com
Liu
Xunyan
X
Li
Ruizhen
R
Nie
Wanping
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D003131:Combined Modality Therapy; D004564:Electrocoagulation / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
D000431:Ethanol