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.