title: Effects of combining transarterial chemoembolization with percutaneous microwave coagulation therapy for hepatocellular carcinoma abutting the diaphragm.
abstract: OBJECTIVE
  This study aims to explore the clinical effectiveness of a combination therapy of transarterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT) in treating hepatocellular carcinoma (HCC) abutting the diaphragm.
  
  
  METHODS
  Six cases with HCC were treated with TACE followed by PMCT one month later with the aid of artificial pneumothorax.
  
  
  RESULTS
  CT/MRI revealed complete necrosis in the tumor lesions and the treated tumor margins (≥ 5 mm). Serum alpha-fetoprotein (AFP) levels markedly declined in patients who originally had higher serum AFP levels. Postoperative complications such as fever, mild hepatic dysfunction and pleural effusion were alleviated within a short period of time. All patients were closely monitored through follow-up; all patients survived, except for one patient who received a liver transplantation.
  
  
  CONCLUSIONS
  As lesions are either invisible or poorly visible in sonography, determining an effective treatment for HCC abutting the diaphragm remains a particular challenge. TACE and PMCT combined therapy with the aid of artificial pneumothorax proved to be an available treatment option.
authors.affiliation: a Department of Oncology , 401th Hospital of PLA , Qingdao , China.
authors.forename: Xingjun
authors.initials: X
authors.lastname: Zhuang
authors.affiliation: b Department of Infectious , Jiaozhou People's Hospital , Jiaozhou , China.
authors.forename: Qinxue
authors.initials: Q
authors.lastname: Wang
authors.affiliation: a Department of Oncology , 401th Hospital of PLA , Qingdao , China.
authors.forename: Ningning
authors.initials: N
authors.lastname: Wang
authors.affiliation: a Department of Oncology , 401th Hospital of PLA , Qingdao , China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Hou
authors.affiliation: b Department of Infectious , Jiaozhou People's Hospital , Jiaozhou , China.
authors.forename: Jianshun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: b Department of Infectious , Jiaozhou People's Hospital , Jiaozhou , China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Chi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D003964:Diaphragm; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011031:Pneumothorax, Artificial / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins
keywords: HCC; PMCT; TACE; artificial pneumothorax; diaphragm