転移性肝癌に対するマイクロ波凝固療法

Abstract

In order to evaluate the effect of microwave coagulation therapy for metastatic liver cancer, nine cases of colorectal cancer and one case of duodenal cancer ware studied. Hepatectomy was not done in all cases. Microwave coagulation therapy was done with sonographically guide percutaneous insertion of a needle-electrode (P-MCT). Treated metastatic liver nodules were under 3cm in diameter. Primary lesions were treated by radical excision. P-MCT was repeated 5 to 6 times to treat one nodule. Six of 10 patients had metachronous liver metastasis. Liver tumors were detected at 4-to 8-month intervals. Whenever a nodule was detected, P-MCT was performed. In 3 of 6 patients there were no signs of recurrence after 12 to 42 months of follow up, including no elevation in CEA levels. Achieving a recurrence-free state in 3 patients with metachronous metastatic liver cancers was the best indication of P-MCT. But multiple liver metastases were found in another two patients who had received P-MCT. In these two patients, P-MCT was not indicated, chemotherapy was also done. Another 4 patients had synchronous liver metas- tasis. Intraoperative microwave coagulation therapy or enucleation of hepatic tumor was done at primary operation. All patients were alive without recurrence of hepatic tumor but with high CEA levels. One patient was found to have a lung metastasis 18 months after primary operation. Chemotherapy was used to treat these 4 patients. It can be concluded that P-MCT is effective in reducing the tumor mass of synchronous liver metastasis, but that combined chemotherapy is necessary.