CT-guided two-step method puncture percutaneous microwave coagulation therapy to patients with hepatocellular carcinoma after TACE

Objective To evaluate the clinical application of CT-guided percutaneous microwave coagulation therapy(PMCT) to patients with hepatocellular carcinoma(HCC) after transarterial chemoembolization(TACE).Methods Thirty-three patients with HCC undertook TACE first.They would undergo either TACE or PMCT based on the results of AFP and liver imaging such as CT/MR after 2 to 4 weeks of the primary TACE.Two-step method puncture was to perform puncture of guiding-needle of PMCT.Firstly,a lumbar-puncture needle(0.6 mm in diameter and 8 cm long) punctured the mass.Secondly,it was to reintroduce the guiding-needle(2.0 mm in diameter and 13.5 cm long) of PMCT,according to the angle and depth between the lumbar-puncture needle and the mass of recheck-CT.Then we introduced the antenna of PMCT and performed PMCT.All patients were followed up between 5 and 48 months(mean,25.5 months).Based on the results of follow-up,therapeutic effect,survival time and recurrence were prospectively evaluated with statistical analysis.Results The 1-,2-and 3-year survival rate and the recurrence rate of the patients treated by TACE and PMCT were 84.23%,72.29%,61.96% and 9.09%,24.24%,33.33%,respectively.Liver abscess(n=2) after PMCT was the only complication.PMCT had no other severe complications and its impairment to liver function was light.Conclusion CT-guided two-step method puncture PMCT to patients with HCC after treated by TACE is an easy and good-fixing operation.And it is safe,effective,practical and worth of clinic application.