Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma

BACKGROUND A small number of microwave electrode insertions and microwave irradiations were used to obtain complete tumor necrosis in hepatocellular carcinomas (HCC) measuring > 2.0 cm but ≤ 3.0 cm in greatest dimension. The efficacy of combining transcatheter arterial chemoembolization (TACE) with subsequent percutaneous microwave coagulation therapy (PMCT) was assessed in this study. METHODS Eighteen patients with cirrhosis and HCCs measuring > 2.0 cm but ≤ 3.0 cm in greatest dimension underwent TACE followed within 1–2 days by ultrasonographically guided PMCT. RESULTS On dynamic computed tomography, 17 of the 18 patients showed complete necrosis of their tumor lesions and the treated tumor margins (≥ 5 mm). Necroses of tumors and noncancerous margins surrounding the tumors were obtained using 4 microwave irradiations (1 session) in 14 patients, 5 microwave irradiations (2 sessions) in 2 patients, and 6 microwave irradiations (2 sessions) in 1 patient. The follow‐up period was short (12–31 mos), and all patients remained alive. No local recurrences in the treated areas were detected. No fatal complications were observed. Pleural effusion was observed in 1 patient only. CONCLUSIONS This combined therapy of PMCT applied within 1–2 days of TACE effectively treated HCCs measuring > 2.0 cm but ≤ 3.0 cm in greatest dimension. A small number of microwave electrode insertions and microwave irradiations were used. Cancer 2000;89:1245–51. © 2000 American Cancer Society. Using a small number of microwave electrode insertions and microwave irradiations, percutaneous microwave coagulation therapy (PMCT) after transcatheter arterial chemoembolization can induce extensive necrosis in hepatocellular carcinomas measuring < 3.0 cm in greatest dimension. This combination therapy can enhance the efficacy of the PMCT and improve patient compliance.