転移性肝腫ように対するマイクロ波凝固療法：治療後の局所再発例からの検討

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Background : Microwave coagulation therapy (MCT) is beginning to be established as less invasive therapy, has been widely applied local ablation therapy for liver tumors. However, the indications for MCT for liver metastases remain controversial. We have examined the possibility of the MCT for the liver metastases.Material and Methods : Open MCT (OMCT) was performed 12 nodules in 6 patients. Intraoperative ultrasonography was used in every case for monitoring lesion and therapeutic effect. Focally recurred 4 out of 12 nodules, among them, 2 nodules underwent hepatic resection, which were used as subject to conduct an examination on the recurrence form and diagnostic character on diagnostic imagings, as well as the pathological analysis.Results : It was diagnosed that until one month after the OMCT, all of the treated 12 nodules became necrotic on dynamic CT scan. It was confirmed that 2 out of 12 nodules (17%) had recurrence on the treated area, and 2 nodules (17%) had recurrence peripheral of the treated area. In the recurrence cases, the tumor marker did not normalized but increased again. In the case of recurrence on the treated area, residual and locally recurrent cancer cells were found in the necrotic tissues, and they were infiltrating surrounding tissues. In the case of recurrence peripheral of the treated area, cancer cells were not found in the necrotic tissues, there were connective tissues between the necrotic tissues and the cancer tissues. In the 2 cases of hepatic resection, there have been no reccurrence 16 month and 9 month after the resection.Conclusion : At this point, in view of its difficulty of making judgement on the effectiveness of the treatment and the risk of local recurrence, it is necessary to limit the adaptation of MCT against liver metastases only to hepatic resection case or high risk cases.

転移性肝腫ように対するマイクロ波凝固療法：治療後の局所再発例からの検討

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