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Microwave coagulation therapy for hepatocellular carcinoma
T Midorikawa1, K Kumada, H Kikuchi
1Department of Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan.
Journal of Hepato-Biliary-Pancreatic Surgery
|September 12, 2000
Summary
Microwave coagulation therapy (MCT) is a safe alternative to hepatic resection for hepatocellular carcinoma (HCC) patients with poor liver function. This treatment offers comparable efficacy in local control without compromising survival rates.
Area of Science:
- Hepatology
- Surgical Oncology
- Interventional Radiology
Background:
- Hepatocellular carcinoma (HCC) poses a significant challenge, particularly in patients with compromised liver function.
- Traditional treatments like hepatic resection (HR) may be limited in patients with impaired hepatic reserve.
- Microwave coagulation therapy (MCT) offers a less invasive approach for HCC management.
Purpose of the Study:
- To evaluate the efficacy and safety of MCT compared to HR in HCC patients with impaired hepatic reserve.
- To analyze preoperative, postoperative, and prognostic factors between the two treatment groups.
- To determine if MCT is a viable alternative to HR for this patient population.
Main Methods:
- Retrospective comparison of 51 patients undergoing HR versus 38 patients undergoing MCT for HCC.
- Analysis of preoperative liver function tests (albumin, prothrombin time, hepaplastin test, technetium-99m galactosyl-human serum albumin uptake, indocyanine green retention rate, Child-Pugh grade).
- Comparison of operative time, blood loss, postoperative liver function, morbidity, mortality, local recurrence, and survival rates.
Main Results:
- MCT group showed significantly poorer preoperative liver function (lower albumin, prolonged prothrombin time, lower hepaplastin test, reduced tracer uptake, higher dye retention, worse Child-Pugh grade) compared to HR group.
- MCT group had significantly shorter operative times and less blood loss.
- No significant differences were observed in postoperative liver function, morbidity, mortality, local recurrence, or survival rates between the groups.
- Treatment type (HR or MCT) was not identified as a prognostic factor.
Conclusions:
- MCT is a safe and effective alternative to HR for HCC patients with impaired hepatic reserve.
- MCT provides comparable local control and survival outcomes to HR in this patient group.
- The findings support the use of MCT to improve treatment options for HCC patients with poor liver function.