Journal of Hong Kong College of Radiologists

Volume 4 Number 1, 2001

Ultrasound Guided Hyperthermal Therapies for Hepatocellular Carcinoma

JW Chen, MD Lu, XY Xie, L Liu, M Kuang, LJ Liang, JF Huang
Department of Hepatobiliary Surgery, First Affiliated Hospital of Sun Yet-sen University of Medical Sciences, Guangzhou, China

Purpose: To evaluate the effect of percutaneous microwave coagulation therapy (PMCT) and percutaneous hot-distilled water injection (PHDI) on the treatment of unresectable hepatocellular carcinoma (HCC).

Patients and methods: Sixty-three HCC patients with 129 tumor nodules were treated with PMCT. The diameter of the nodules ranged from 1cm to 6.4cm (average 2.7±1.4cm). PHDI was performed for 47 patients who were unsuitable for PMCT due to tumor located near important anatomic structures or poor liver functional reserve. Sixty-nine nodules were treated with the average diameter of 2.5 0.6cm were treated.

Results: Of the nodules treated with PMCT, 93.8% achieved complete necrosis judging by imaging examination. Fine needle biopsy with multiple samples from different parts of the tumor was performed in 75 treated nodules and no viable tumor was detected in 69 (92.0%) of them. The 12- and 24- month survival rate was 95.2% and 86.4% respectively. The local recurrence rate was 5.4%. For patients treated with PHDI, 81.2 % of the nodules was complete necrosis and no viable tumor cell was found in 77.8% of the 18 nodules received biopsy. The 12- and 24- month survival rate was 97.8% and 82.6%. The local recurrence rate was 7.2%.

Conclusion: PMCT is not only effective for small HCC tumors but can laso be extended to large HCC tumors with reliable tumor ablation. PHDI is safe and useful for patients with poor liver function, tumor beneath important intrahepatic structures. (J HK Coll Radiol 2001;1:59-64)

Key words : Hepatocellular carcinoma, Interventional ultrasound, Hyperthermia, Microwave

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