Microwave Coagulonecrotic Therapy for Hepatocellular Carcinoma

Yamanaka, Naoaki; Tanaka, Tsuneo; Oriyama, Takeshi; Furukawa, Kazutaka; Tanaka, Wataru; Okamoto, Eizo

doi:10.1007/s002689900163

Cited by 63 publications

(37 citation statements)

References 9 publications

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“…Yamanaka et al [50] compared the therapeutic effects of MWA in 27 patients with that of hepatectomy in 23 patients. MWA was performed laparoscopically in 8 patients and intraoperatively in 19 patients.…”

Section: Clinical Applicationmentioning

confidence: 99%

Microwave Ablation of Hepatocellular Carcinoma

2007

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Objective: This article reviews the basic principles, equipment, current therapeutic status and future trends of microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC). Methods: All articles published in English on MWA or MWA as a treatment for HCC were identified with a PubMed search from the 1990s through June 2007. Papers were reviewed on the technical advances of MWA equipment and the clinical applications of MWA including indications, techniques, therapeutic outcomes, complications and combination therapies. Results: MWA has several advantages, including high thermal efficiency, higher capability of coagulating blood vessels, faster ablation time, and an improved convention profile. MWA can induce large ablation volumes and yield good local tumor control, especially for small HCC. Larger HCC can also be completely ablated by using more effective antenna or simultaneous application of multiple antennae. Long-term survival comparable to that of surgery was obtained for tumors measuring 4 cm or less. Associated complications appear to be low. Conclusions: MWA is a promising minimally invasive technique for the treatment of HCC. Future advances are warranted to improve the therapeutic efficacy.

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Section: Clinical Applicationmentioning

confidence: 99%

Microwave Ablation of Hepatocellular Carcinoma

2007

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IntroductionAlthough surgical resection is still considered as a primary option for the treatment of liver malignancies [1,2,3], less invasive therapies, including intraoperative cryosurgery [4], ethanol injection [5,6], microwaves [7,8], interstitial laser therapy [9], focused ultrasound [10,11], and radio-frequency ablation (RFA) [12,13,14,15,16,17,18,19,20,21,22] have been developed as alternatives to conventional surgery. Among these approaches, RFA has shown the greatest potential in recent experimental and clinical research owing to its low invasiveness, simplicity, and favorable cost-effectiveness.

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confidence: 99%

Treatment of VX2 liver tumor in rabbits with "wet" electrode mediated radio-frequency ablation

Miao

Mulier

et al. 2000

European Radiology

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Radio-frequency ablation (RFA) has been considered as an alternative therapy for liver tumors. A "wet" electrode with interstitial infusion of hypertonic saline was tested for the RFA of liver tumor in rabbits. Seventy-eight liver tumors ( 1.5 to 3.0 cm) were induced in 41 rabbits by VX2 carcinoma implantation. Fifty-one tumors in 27 rabbits were treated with RFA. Under laparotomy, the RF energy was delivered while 5 % saline was infused through the electrode into the tumor at 1 ml/min. Six rabbits with 12 tumors were treated with only intratumoral 5 % saline infusion without RFA. Another 8 rabbits with 15 tumors received sham operation as untreated controls. The efficacy of the therapy was evaluated with survival rate, MRI, microangiography, and histopathology. In the RFA group, 6 rabbits survived longer than 6 months (absolute eradication rate 22.2 %); 12 rabbits were found free of viable tumor at the moment when they were sacrificed (relative eradication rate 44.4 %); 9 rabbits showed local tumor relapse and/or lung metastasis 2-10 weeks after ablation (recurrent rate 33.3 %). In control groups of saline infusion and sham operation, all 14 rabbits died within 3 months (mortality rate 100 %). Three-month survival rates between RFA group and control groups were significantly different (p < 0.05). Findings of MRI, microangiography, and histology supported these outcomes. Radical treatment of liver malignancy in rabbits is possible with the present modified RFA technique. Its clinical usefulness has to be further proven.

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“…Recently, several effective nonsurgical palliative modalities have been developed; these include TACE [3], TAI [4], PEIT [6,7], MCT [5], and RFA [8], each of which has proved effective on its own in HCC [1,2]. Typically, PEIT, MCT, or RFA has been used for HCC with 3 lesions, each <3 cm in diameter [1]; however, none of these approaches has been found effective in the treatment of multiple HCC with >3 lesions of >3 cm.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with advanced HCC with multiple intrahepatic metastases, multidisciplinary treatment has often been performed; this has consisted of hepatic arterial embolization [3] or lipiodolization [4], microwave coagulation therapy [5], percutaneous ethanol injection [6,7], and radiofrequency ablation (RFA) [8]. The rational implementation of these palliative modalities provides the surgeon with the opportunity to play a key role in the management of these patients.…”

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confidence: 99%