[Ultrasound-guided percutaneous microwave coagulation therapy for primary hepatocellular carcinoma]

To evaluate the long-term results of percutaneous microwave coagulation therapy (PMCT) for primary hepatocellular carcinoma.

From May 1994 to May 2000, 177 hepatocellular carcinoma patients with 265 nodules underwent PMCT with ultrasound (US) guidance. The tumor size varied from 1.5 to 8.7 cm (median 4.12 + 1.9 cm). Follow-up examination was carried out with colour US, CT, MRI and AFP. 184 nodules were re-biopsied during the follow up of 5 - 74 months (median 29 months).

After PMCT, colour Doppler flow signals disappeared in 92.0% (207/225) of patients. No enhancement was observed in 88.5% (138/156) by CT and 88.9% (32/36) by MRI. Re-biopsy of 184 nodules showed complete necrosis in 92.4% (170/184). Six resected lesions showed complete tumor necrosis in 5 and subtotal necrosis in 1. The 1- to 5-year survival rates were 90.1%, 76.9%, 68.3%, 64.2% and 57.8%, respectively. The survival rates of the well differentiated lesions were better than those of the poorly ones (P < 0.05). But there was not statistical significance between the moderately and the well differentiated ones. The new lesions development rates in 1 to 5 years were 26.1%, 37.8%, 43.5%, 48.6% and 58.9%, respectively. However, there was no severe complication.

Ultrasound-guided microwave coagulation is safe and effective for primary hepatocellular carcinoma. It can eliminate tumors less than 5 cm in diameter.