Ultrasound-guided percutaneous ethanol injection combined with microwave ablation for treating liver cancer in special site after TACE / 中国介入影像与治疗学

ABSTRACT

Objective To explore the safety and efficacy of ultrasound-guided percutaneous ethanol injection (PEI) combined with microwave ablation for treating early- and middle-stage primary liver cancer in special site, i.e. tumors adjacent to gallbladder, dome of diaphragm, heart, gastrointestinal tract, kidney or blood vessels (with the shortest distance to the vital organ/tissue ≤0.5 cm). Methods One week after TACE, 40 patients with early- or mid-stage primary liver cancer in special sites were treated with ultrasound-guided PEI combined with microwave ablation. Absolute ethanol was injected into the tumor from the side near the vital organ/tissue. Then microwave ablation was performed with low power (40-50 W) and short time (4-5 min). After operation, the adverse reactions and complications were observed, and the efficacy was evaluated during following-up. Results There was no serious adverse reaction nor complication after treatment, only abdominal pain (17/40, 42.50%), fever (15/40, 37.50%), nausea and vomiting (12/40, 30.00%) were observed, and the patients then recovered after symptomatic treatment. A small amount of pleural effusion was found in 2 patients, and then gradually disappeared. One month after discharge, the complete ablation rate of tumor was 97.50% (39/40). Local tumor recurrence was noticed in 4 patients during 12 months' following-up. Conclusion Ultrasound-guided PEI combined with microwave ablation is safe and effective for treatment of early-and middle-stage primary liver cancer in special sites.