Standards for Selecting Percutaneous Ethanol Injection Therapy Or Percutaneous Microwave Coagulation Therapy for Solitary Small Hepatocellular Carcinoma: Consideration of Local Recurrence

Horigome, Hideo; Nomura, Tomoyuki; Saso, Katsuhisa; Itoh, Makoto

doi:10.1111/j.1572-0241.1999.01230.x

Cited by 47 publications

(23 citation statements)

References 8 publications

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“…38 The MCT has been reported to be superior to PEI for the treatment of patients with HCCs less than or equal to 15 mm in diameter. 41 However, the coagulated area produced by MCT is usually smaller than the area produced by RFA, thus more MCT sessions are usually required to produce complete tumor response. 12,13 Laser interstitial thermal ablation therapy has the advantage of being less painful, but the application is usually limited by the relatively small zone of coagulation produced per each probe placement, as similar to MCT.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

et al. 2008

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According to the American Association for the Study of Liver Diseases guidelines, percutaneous ethanol injection (PEI) is a safe and highly effective treatment for small hepatocellular carcinomas (HCC) and should be the standard against which any new therapy is compared. The primary purpose of this study was to identify survival benefit of any percutaneous ablation therapy as compared with PEI in the treatment of patients with unresectable HCC. The secondary endpoints were initial tumor response, local tumor progression, and complications. Randomized controlled trials that compared pecutaneous ablative therapies with PEI were included. MEDLINE, the Cochrane Library, CANCERLIT, and manual search from 1978 to July 2008 were used. To control the potential heterogeneity, the random effects model of DerSimonian and Laird was used for a meta-analysis. Egger's test was performed to test a potential publication bias. We identified seven randomized controlled trials (RCTs), but only four RCTs including 652 patients that compared radiofrequency ablation (RFA) with PEI met the inclusion criteria to perform a meta-analysis assessing 3-year survival.

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Section: Discussionmentioning

confidence: 99%

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

et al. 2008

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“…The extent of the coagulation achieved by microwave irradiation is related to the diameter of the electrode, the amount of electric power used, the irradiation time (1,4) and the heat loss via circulation. Therefore, thickening of the electrode, long irradiation or increasing electric power can enlarge tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous microwave coagulation therapy (PMCT) has been used for the local treatment of either hepatocellular carcinoma (HCC) or metastatic liver tumors (1)(2)(3)(4)(5). In previous studies, PMCT has demonstrated the feasibility of efficaciously treating small HCC measuring ≤2.0 cm in diameter with a 5-year survival rate of about 70% (3).…”

Section: Introductionmentioning

confidence: 99%

“…The coagulated areas induced by PMCT with one microwave electrode insertion are small. Therefore, to produce extensive necrosis not only of the tumor but also including the neighboring non-cancerous tissue, multiple microwave electrode insertions were required (3,4). For example, 3-6 electrode insertions were required for HCCs measuring ≤2.0 cm and more than 6 electrode insertions were required for HCCs measuring >2.0 to ≤3.0 cm in diameter.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous microwave coagulation therapy for hepatocellular carcinoma: Increased coagulation diameter using a new electrode and microwave generator

Inokuchi

Seki²,

Ikeda³

et al. 2010

Oncol Rep

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Abstract. We performed percutaneous microwave coagulation therapy (PMCT) using a new microwave electrode and microwave generator to lessen the number of microwave electrode insertions for hepatocellular carcinoma (HCC) measuring ≤3.0 cm in diameter. In this study, we assessed the efficacy of this new system. Fifty-two patients with liver cirrhosis and HCC measuring ≤3.0 cm in diameter (tumor size: ≤2 cm, 27 patients; >2 to ≤2.5 cm, 13 patients; >2.5 to ≤3 cm, 12 patients) underwent PMCT using a new microwave coagulation system under ultrasonographic guidance. Fortytwo of 52 patients showed complete necrosis of the tumor lesion with a treated margin ≥5 mm on dynamic computed tomography. Necrosis of HCC and the non-cancerous area surrounding the tumor was obtained by a single needle insertion in 23 patients (tumor size: ≤2 cm, 23 patients), by two needle insertions in 11 patients (tumor size: ≤2 cm, 4 patients; >2 to ≤2.5 cm, 5 patients; >2.5 to ≤3 cm, 2 patients), and by three needle insertions in 8 patients (tumor size: >2 to ≤2.5 cm, 5 patients; >2.5 to ≤3 cm, 3 patients). During the follow-up period of 5-34 months, all patients remained alive. Among the patients showing complete necrosis of HCC with a treated margin ≥5 mm, we have not detected local recurrences. On the other hand, 4 of the 10 patients who could not obtain the treated margin of ≥5 mm, experienced a local recurrence. No fatal complications were observed. However, bile duct stricture was observed in 2 patients. The new microwave coagulation system can induce extensive necrosis with a small number of microwave electrode insertions. This system may enhance the efficacy of PMCT for HCC measuring <3.0 cm in diameter.

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“…Such a drawback imposed to use large antennas and to deliver energy for a short time, achieving small ablation areas and requiring multiple insertions even in the presence of small tumors. [2,3] Internally-cooled MCT partially reduced this problem, allowing for the increase of the ablation time and the amount of power that could be safely delivered. [4] The introduction into the distal portion of the antenna of a choke coil was proposed to reduce back heating effects.…”

Section: To the Editormentioning

confidence: 99%

Microwave coagulation therapy: the future is quite rosy

Tombesi¹,

Vece²,

Sartori³

2015

Hepatoma Res

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Standards for Selecting Percutaneous Ethanol Injection Therapy Or Percutaneous Microwave Coagulation Therapy for Solitary Small Hepatocellular Carcinoma: Consideration of Local Recurrence

Abstract: The selection of PEIT or PMCT to treat patients with HCC should be based on tumor size and cell differentiation.

Cited by 47 publications

References 8 publications

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

Percutaneous microwave coagulation therapy for hepatocellular carcinoma: Increased coagulation diameter using a new electrode and microwave generator

Microwave coagulation therapy: the future is quite rosy

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