Intraoperative microwave coagulation therapy for large hepatic tumors

Area of Science:

• Hepatobiliary Surgery
• Interventional Oncology
• Minimally Invasive Therapies

Background:

• Large liver neoplasms often present challenges due to poor liver function or difficult tumor location.
• Existing treatments may have limitations for specific patient groups requiring novel approaches.

Observation:

• Anterolateral thoracotomy provided optimal operative fields for right lobe tumors.
• IMCT utilized specific microwave settings (60 W, 45s coagulation/1s dissociation) with electrode needles.
• Hepatoduodenal ligament clamping and targeted irradiation ensured regional necrosis with a safe margin.

Findings:

• Successful treatment of three patients (two with hepatocellular carcinoma, one with liver metastasis) using the described IMCT techniques.
• Postoperative imaging confirmed therapy-induced necrosis with no enhancement, indicating treatment efficacy.
• One patient required subsequent transcatheter embolization (TAE) due to tumor recurrence, highlighting the potential benefit of combination therapy.

Implications:

• Intraoperative microwave coagulation therapy is a safe, active, and non-toxic option for large hepatic tumors.
• IMCT is particularly valuable for patients with hepatocellular carcinoma and compromised liver function.
• Combining IMCT with TAE may offer superior outcomes, especially for tumors with viable residual components.