ABSTRACT
Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.
ABSTRACT
Objective:To explore the effect of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy(PMCT) on treatment of patients with hepatic carcinoma.Methods: The clinical data of 60 cases of liver cancer patients in our hospital in TACE combined with PMCT were analyzed. Results:The operation was successfully performed, no serious complications and death. Efficacy: 4 CR cases, 38 PR cases, 16 SD cases, 2 PD cases, the total efficiency of treatment was 70.0%; After 1, 2, 3 year, survival cases (ratio) were respectively: 46(76.7%), 35(58.3%), 31(51.7%); The levels of Serum alpha fetoprotein (AFP) after operation was significantly reduced, after treatment, the patient's liver function improved significantly; The diameter of the lesions was significantly reduced.Conclusion: TACE combined with PMCT is an effective therapy for hepatic carcinoma.
ABSTRACT
Objective To study the results of repeat hepatectomy,followed by transcatheter arterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT),but with or without portal vein chemotherapy (PVC) in patients with recurrence of hepatocelluar carcinoma (HCC) after partial hepatectomy.Methods The data of 33 patients were analyzed retrospectively.All these patients received repeat hepatectomy.They were then divided into two groups:the PVC group (n =19) was treated with PVC + TACE + PMCT,and the non-PVC group (n =14) with TACE + PMCT.Results For the 33 patients,13 (39.4％) developed tumor recurrence ＞2 years from the initial resection while 20 patients (60.6％) developed recurrence within ≤ 2 years.The tumor recurrence consisted of local recurrence in 14 patients (42.4％),and heterochronous recurrence in 19 patients (57.6％).There was a significantly difference in the cumulative survival rates between the two groups (x2 =4.319; P =0.038).The 1y,3y,5y survival rates were 84.2％,42.1％,31.6％ in the PVC Group,and 71.4％,28.6％,14.3％ in the Non-PVC Group respectively.28 sessions of PMCT and 97 sessions of TACE were performed postoperatively (the medians were 1,0.5; 3,3 respectively,the mean ranks were 17.68,16.07; 15.05,19.64 respectively,and the P values were 0.612,0.163 respectively between the two groups).Conclusions For patients with recurrence of HCC after hepatic resection,after repeat hepatectomy PVC + TACE + PMCT gave better survival than those with TACE + PMCT but without PVC.
ABSTRACT
Objective:To evaluate the clinical value of percutaneous microwave coagulation therapy for peripheral non-small-cell lung cancer. Methods:We evaluated 35 patients with non-small-cell lung cancer who received percutaneous microwave coagulation therapy and 35 patients who received radiotherapy from March 2004 to September 2006;the patients were sex-matched, age-matched, and had the same pathology and clinical staging. Clinical effects were observed and assessed. Survival rate were calculated using the Kaplan-Meier method. The difference in survival rate between the two treatment methods was analyzed using a log-rank test. Results:The 1-year, 3-year, and 5-year survival rates for the microwave coagulation therapy group (71.4%, 40.0%, and 20.0%, respectively) were significantly higher than those for the radiation therapy (51.4%, 22.9%, and 11.4%, respectively) (P<0.05). Conclusion:Percutaneous microwave coagulation therapy is a minimally invasive, safe, and effective alternative for patients with peripheral non-small-cell lung cancer who cannot undergo routine surgery because of poor heart and lung function or fear of surgical trauma.
ABSTRACT
Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.
ABSTRACT
Objective To explore the clinical value of B ultrasound-guided psychro-circulation percutaneous microwave coagulation therapy(PMCT) in the treatment of liver cancer.Methods One hundred and sixteen liver cancer patients with 154 lesions were selected to receive psychro-circulation PMCT in our department from July 2004 to December 2007.The pre-and postoperative alpha fetoprotein(AFP) levels were detected.The diameters and blood flow state of the tumors were measured and compared by use of B ultrasound and computerized tomographic scanning(CT).The postoperative 1,2 and 3 y survival rate of those patients was followed up and recorded.Results No mortality or severe complications occurred in this series.Preoperative serum AFP level of the patients was(421.6?36.5)?g/L and decreased obviously to(232.5?25.6)?g/L at 1 month after psychro-circulation PMCT(P