Thermal Ablation Using Microwave Coagulation Therapy (MCT) and Radiofrequency Ablation (RFA) for Hepatocellular Carcinoma

Abstract

Thermal ablation can be achieved using microwave coagulation therapy (MCT) and radiofrequency ablation (RFA), and has been developed as a curative and minimally invasive treatment for hepatocellular carcinoma (HCC). A percutaneous, endoscopic, or open body approach can be selected based on the size, number, and location of the tumors. MCT is achieved with monopolar-type electrodes to create a columnar ablative area with a 1 cm diameter centered around the electrode. RFA is achieved with internally cooled electrodes (Cool-tip^TM) or expandable electrodes (LeVeen^TM and RITA^TM). RFA can produce a spheroidal ablative area with a 3 cm diameter surrounding the needle. Three- and 5- year overall survival rates are 80.0-81.0% and 43.0-78.0% for MCT, and 62.0-77.7% and 33.3-55.4% for RFA, respectively. Morbidity and mortality rates using thermal ablation are 2.2-8.9% and 0.3-0.5%, respectively. Thermal ablation, using MCT or RFA, can provide a favorable long-term prognosis with low morbidity rates for HCC patients with poor liver function reserves.