Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients.

OBJECTIVE: The objective of our study was to evaluate the long-term results of percutaneous microwave coagulation therapy for the treatment of hepatocellular carcinoma in a large patient population. SUBJECTS AND METHODS: Survival rates were determined in 234 patients with 339 nodules of hepatocellular carcinoma who had undergone percutaneous microwave coagulation therapy (208 men, 26 women; mean age, 54.8 years; mean tumor size, 4.1 +/- 1.9 cm; range, 1.2-8.0 cm; mean follow-up period, 27.9 months). Patients were those who had been rejected as candidates for surgery by the surgery department, who fit our study's criteria, and who agreed to participate. After baseline imaging studies were performed, the patients were followed up using the same combination of imaging (sonography, CT, or MR imaging) and posttreatment biopsy.
RESULTS: After percutaneous microwave coagulation therapy, color Doppler flow signals disappeared in 92.0% (263/286) of the lesions. No enhancement was apparent in 89.2% (190/213) and 89.1% (41/46) of the lesions on contrast-enhanced CT and MR imaging, respectively. Posttreatment biopsies of 194 nodules showed no evidence of surviving tumor tissue in 180 nodules (92.8%). Resections of six lesions revealed complete tumor necrosis in five. The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 92.70%, 81.60%, 72.85%, 66.37%, and 56.70%, respectively. The relationships between survival curves and the degree of hepatocellular carcinoma tumor differentiation and between survival curves and tumor size were statistically significant (p = 0.021). No severe complications were seen.
CONCLUSION: Sonographically guided microwave coagulation proved to be safe and effective for the treatment of hepatocellular carcinoma. This therapy resulted in a high percentage of cases without evidence of residual tumor and satisfactory long-term results.