Evaliation of percutaneous thermocoagulation therapy for hepatocellular carcinoma under interruption of hepatic blood flow

With the aim of achieving curable a radical coagulation for hepatocellular carcinoma by a single treatment, we have developed and reported a therapeutic method of percutaneous thermocoagulation under interruption of the hepatic blood flow. In the present study, the treatment outcome of thermocoagulation therapy is compared with that of hepatic resection performed in the same period, allowing a controlled evaluation of our therapeutic modality. We examined 52 cases with solitary hepatocellular carcinoma of less than 5cm in diameter which had not been treated before. The first-line therapy for these patients was percurtaneous thermocoagulation under interruption of the hepatic blood flow, and when it was difficult to carry our the thermocoagulation therapy involving a wide margin of non-cancerous tissues around the tumor, e.g., a lesion not depictable by echography, a superficial lesion of the liver and a lesion adjacent to the large vessel were chosen for hepatic resection. The hepatic blood flow was interrupted by an intravenous balloon at the outlet of the liver, then blockage of the portal blood flow was ensured by CTAP (computerized tomography aortoportography), and the hepatic artery was embolized. Thermocoagulation was achieved by percutaneous insertion of a microwave- or radiofrequency-emitter, making it a rule to cause coagulation at a time. The treated patients consisted of group A ; 26cases who recieved percutaneous thermocoagulation therapy under interruption of the hepatic blood flow (microwave n=21 ; radiofrequency n=5), and group B ; 26 cases who underwent hepatic resection. The mean tumor diameters in group A and B were 24.0±8.1mm and 33.7±10.1mm, respectively. The mean postoperative hospitalization periods for gruoup A and B were 11±3 days and 22±9 days, respectively, showing a statistically significant difference between these two groups (p