Abstract:
Objective To evaluate the efficacy and safety of Percutaneous microwave coagulation therapy (PMCT) for liver tumor abutting the gastrointestinal tract, the gallbladder, the diaphragm, the heart, the kidney and the other danger areas (the shortest distance of tumor from the organ ≤ 0.5cm) , to explore the optimal ablation condition in order to achieve complete tumor necrosis while these organs were not burn obviously.Methods This study was undertaken in 45 patients who were with liver cancer abutting the gastrointestinal (4 patients) , the gallbladder (10 patients) , the diaphragm (24 patients) , the heart (9 patients) , the kidney (3 patients) and accepted PMCT.All the patients underwent ultrasound and enhanced CT scan before and after the treatment, detection of AFP, liver and kidney function to determine efficacy.Adverse reaction and complication rates, changes of serum AFP, and tumor response rate were observed.Results ⑴According to the results of the CT scan, there were 38 cases of complete tumor necrosis after 8 weeks, necrosis rate is 84.44%;23 cases of AFP turning to negative after 4 weeks (65.71%) in 35 cases of AFP positive patients before operation.There was no difference in efficacy compared that of reported in the literature of non-hazardous area liver cancer.⑵1 patient who was with liver cancer close to the top of the diaphragm developed hemothorax after PMCT treatment, the hemorrhage was absorbed after 7 days of hemostasis treatment;The ablation tip was tearing off and remained in the central area of ablation in 1 patient who was asymptomatic.After 1-year following-up, there was no change in the tip position.There were no other complications arose with the operation.Conclusion The efficacy of a proper PMCT treatment for the liver cancer near danger area is closed to that of PMCT for non-hazardous area, and the complications associated with the operation could be avoid.