Ultrasound-guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma complicated by poor-grading liver function

Objective To explore the effect and feasibility of ultrasound-guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma complicated by poor-grading liver function(Barcelona staging).Methods Twenty-seven patients of small hepatocellular carcinoma with hepatic function of Child-Pugh grade B or C were enrolled in this study.A total of 36 lesions were detected.Ultrasound-guided percutaneous microwave coagulation therapy was carried out in all the patients.According to the tumor size and patient's tolerance,proper microwave emission power and action time were adopted.One month after the treatment,ultrasonography was performed to observe the micro-vascular changes within the tumor,and the occurrence of complications was recorded.Results Ultrasonography performed at one month after the treatment showed that the ablation rate of the lesions with single treatment was 88.9%(32/36),these tumor nodules had undergone complete coagulation necrosis,and no blood perfusion into the lesions could be found in all blood-flow phases imaging.Incomplete coagulation necrosis was seen in the remaining four lesions(4/36,11.1%),and there was residual active tumor tissue at the outside area of the tumor nodule.The ultrasound-guided percutaneous microwave coagulation therapy had to be carried out again,and the lesions became completely ablated after the second treatment.All the patients were followed up for 3-16 months.During the follow-up period,four patients developed new lesions at the peripheral area of the original tumor or at other hepatic segments,and three patients died from deteriorated hepatic failure and one patient died from upper gastrointestinal tract bleeding.No recurrence was seen in the other patients.Conclusion For small hepatocellular carcinoma complicated by poor-grading liver function,ultrasound-guided percutaneous microwave coagulation is an effective and mini-invasive therapy with less influence on liver function.Besides,this therapy can be repeatedly employed.