Medhat Eman, Abdel Aziz Ashraf, Nabeel Mohammed, Elbaz Tamer, Zakaria Zeinab, Shousha Hend, Amer Ayman, Fouad Fathalah Waleed, Maher Rabab, Musa Shereif
Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Fellow of Tropical Medicine, Cairo University Student Hospital, Cairo, Egypt.
J Dig Dis. 2015 Aug;16(8):456-63. doi: 10.1111/1751-2980.12259.
Thermal ablative therapies continue to be favored as a safe and effective treatment for patients with non-resectable hepatocellular carcinoma (HCC). Percutaneous microwave ablative therapy, which is a relatively new technique, has the advantage in providing faster ablation of large tumors. This study aimed to evaluate microwave ablation in the treatment of large HCC (5-7 cm) and to assess its effect on local tumor progression, prognostic outcome and patients' survival.
In all, 26 patients with large HCC lesions (5-7 cm) were managed in the multidisciplinary clinic of Kasr Al Ainy University hospital using microwave ablation. The treatment was performed with the patient under conscious sedation and analgesia and ultrasonography-guided using an HS AMICA microwave machine operating at frequency of 2450 MHz and a power up to 100 W. Multiple needle insertions were made in one or two sessions according to the size of the lesion. The complete ablation rate, local tumor progression and patients' overall survival were analyzed, and the efficacy and safety of MWA was evaluated.
Complete ablation was achieved in 19/26 (73.1%). Local tumor progression was recorded in five treated lesions (19.2%). Distant tumor progression within the liver was recorded in six patients (23.1%), with a mean survival of 21.5 months. No procedure-related major complications or deaths were observed.
Percutaneous microwave ablation is safe and effective in the treatment of large HCC tumors. Patients' survival and local tumor control were acceptable.
热消融疗法仍然是不可切除肝细胞癌（HCC）患者安全有效的治疗方法。经皮微波消融疗法是一种相对较新的技术，在快速消融大肿瘤方面具有优势。本研究旨在评估微波消融治疗大肝癌（5 - 7厘米）的效果，并评估其对局部肿瘤进展、预后结果和患者生存的影响。
总共26例大肝癌病灶（5 - 7厘米）患者在开罗大学医学院艾因·凯瑟医院的多学科诊所接受微波消融治疗。治疗在患者清醒镇静镇痛下进行，使用频率为2450兆赫、功率高达100瓦的HS AMICA微波机在超声引导下进行。根据病灶大小在一次或两次治疗中进行多次针穿刺。分析完全消融率、局部肿瘤进展和患者的总生存率，并评估微波消融的疗效和安全性。
19/26（73.1%）实现了完全消融。5个治疗病灶（19.2%）记录到局部肿瘤进展。6例患者（23.1%）记录到肝内远处肿瘤进展，平均生存期为21.5个月。未观察到与手术相关的重大并发症或死亡。
经皮微波消融治疗大肝癌肿瘤安全有效。患者的生存和局部肿瘤控制情况可以接受。
