Objective: To evaluate the long-term results of percutaneous microwave coagulation therapy (PMCT) for primary hepatocellular carcinoma.
Methods: 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).
Results: 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.
Conclusion: Ultrasound-guided microwave coagulation is safe and effective for primary hepatocellular carcinoma. It can eliminate tumors less than 5 cm in diameter.