Percutaneous microwave coagulation therapy under interruption of hepatic blood flow in two patients with hepatic metastasis from gastric cancer

Abstract

Percutaneous microwave coagulation therapy, one of the interdisciplinary therapies for hepatic tumors, is beginning to be established as less invasive therapy. Herein, we report on two patients with hepatic metastasis from gastric cancer who underwent percutaneous microwave coagulation therapy under interruption of the hepatic blood flow as a means of local control of the hepatic metastasis focus.Patient 1 : A 73-year-old male underwent distal gastrectomy and extended resection of the posterior hepatic region for a 10cm single hepatic metastasis focus in the posterior region of the right lobe of the liver. These operations were performed simultaneously in September 1997. Percutaneous microwave coagulation therapy under interruption of the hepatic blood flow was performed for isolated recurrence of cancer of the liver segment 4 and segment 8 in July 1998. Later, the patient had recurrence of cancer in the segment 8, and underwent hepatic arterial chemoembolization twice but the tumor continued to grow. He exhibited marked jaundice from November 1999 and died of hepatic failure in January 2000.Patient 2 : A 72-year -old male underwent total gastrectomy involving combined resection of the gallbladder, spleen, and transverse colon in June 1996. In May 1998, a 1cm metastasis focus in the liver segment 5 was detected and percutaneous microwave coagulation therapy under interruption of the hepatic blood flow was performed. In October 1999, a new metastasis focus in the liver segment 6 was resected. At present, the patient is doing well without any sign of recurrence of cancer.It was thought that the thermal coagulation area expanded by interruption of the hepatic blood flow made it possible to coagulate not only metastatic foci detected by imaging but also the metastatic foci detected by microscope. When hepatic metastasis focus develops in an isolated small area, percutaneous microwave coagulation therapy under interruption of the hepatic blood flow was considered to be a useful means for local control comparable to hepatectomy.