Percutaneous microwave coagulation therapy for hepatocellular carcinoma: increased coagulation diameter using a new electrode and microwave generator.
We performed percutaneous microwave co-agulation therapy (PMCT) using a new microwave electrode and microwave generator to lessen the number of microwave electrode insertions for hepatocellular carcinoma (HCC) measuring <or=3.0 cm in diameter. In this study, we assessed the efficacy of this new system. Fifty-two patients with liver cirrhosis and HCC measuring <or=3.0 cm in diameter (tumor size: <or=2 cm, 27 patients; >2 to <or=2.5 cm, 13 patients; >2.5 to <or=3 cm, 12 patients) underwent PMCT using a new microwave coagulation system under ultrasonographic guidance. Forty-two of 52 patients showed complete necrosis of the tumor lesion with a treated margin >or=5 mm on dynamic computed tomography. Necrosis of HCC and the non-cancerous area surrounding the tumor was obtained by a single needle insertion in 23 patients (tumor size: <or=2 cm, 23 patients), by two needle insertions in 11 patients (tumor size: <or=2 cm, 4 patients; >2 to <or=2.5 cm, 5 patients; >2.5 to <or=3 cm, 2 patients), and by three needle insertions in 8 patients (tumor size: >2 to <or=2.5 cm, 5 patients; >2.5 to <or=3 cm, 3 patients). During the follow-up period of 5-34 months, all patients remained alive. Among the patients showing complete necrosis of HCC with a treated margin >or=5 mm, we have not detected local recurrences. On the other hand, 4 of the 10 patients who could not obtain the treated margin of >or=5 mm, experienced a local recurrence. No fatal complications were observed. However, bile duct stricture was observed in 2 patients. The new microwave coagulation system can induce extensive necrosis with a small number of microwave electrode insertions. This system may enhance the efficacy of PMCT for HCC measuring <3.0 cm in diameter.
Inokuchi
Ryosuke
R
Department of Gastroenterology and Hepatology, Kansai Medical University, Moriguchi, Osaka 570-8507, Japan.
Seki
Toshihito
T
Ikeda
Kozo
K
Kawamura
Rinako
R
Asayama
Toshiki
T
Yanagawa
Masato
M
Umehara
Hideto
H
Okazaki
Kazuichi
K
D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002779:Cholestasis / Q000209:etiology; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D013552:Swine; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome