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6. Intraoperative microwave tissue coagulation as treatment for patients with nonresectable hepatocellular carcinoma

Author

Hamazoe, Ryuichi, Hirooka, Yasuaki, Ohtani, Shinji, Katoh, Takashi, and Kaibara, Nobuaki

Subjects
Liver cancer -- Care and treatment, Operative ultrasonography -- Usage, Health
Abstract

Background. The microwave tissue coagulator (2450 MHz) has been used clinically in the treatment of hepatocellular carcinoma (HCC) to transection of the liver parenchyma and has proven an excellent method for hemostasis. There are, however, few reports on the application of this coagulator to the induction of tumor necrosis. Methods. Microwave tissue coagulation (MTC) was applied at laparotomy in eight patients with nonresectable multiple HCCs. All patients were treated with a combination of resection or intrahepato-arterial chemotherapy and MTC. A total of 222 bouts of MTC were applied to 21 tumors, the largest of which was 65 mm in largest dimension. The monopolar needle electrode was inserted directly into the tumor and the procedure was repeated at approximately 5 mm intervals. Results. Levels of alpha-fetoprotein in serum were found to have decreased in all patients one month after surgery with MTC. Contrast-enhanced computerized tomography (CT) showed the complete absence of blood flow in all tumors subjected to MTC. Needle biopsy one month after MTC confirmed tumor necrosis in all cases. All patients are alive at the time of this report, with the longest survival period being 24 months. In three of eight patients, new tumors were confirmed by angiographic CT at sites separate from the treated tumors. MTC resulted in fewer adverse effects on liver function and less extensive inflammatory reactions than liver resection. Conclusion. Intraoperative MTC appears to be an effective method for inducing local tumor necrosis, and may be of use in combination with palliative surgery for multiple HCC when radical liver resection is not feasible.

Published
1995

7. Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer: final results of a randomized controlled study

Author

Hamazoe, Ryuichi, Maeta, Michio, and Kaibara, Nobuaki

Subjects
Cancer -- Thermotherapy, Stomach cancer, Health
Abstract

Background. Continuous hyperthermic peritoneal perfusion (CHPP) with a solution that contained 10 ug/ml mitomycin C was devised initially as a method for intra-peritoneal thermochemotherapy. The authors conducted a randomized clinical trial to evaluate the efficacy of CHPP as a prophylactic treatment for prevention of peritoneal recurrence of gastric cancer with serosal invasion. Methods. Between January 1983 and October 1986,82 patients with gross serosal invasion but no gross peritoneal metastasis were divided by random sampling into two groups before undergoing potentially curative surgery for gastric cancer: 42 patients were scheduled to receive CHPP, whereas 40 were not scheduled to receive this treatment. CHPP was administered immediately after closing the abdomen after gastric resections while the patients were still on the operating table under general anesthesia. Results. The 5-year survival rate (64.2%) of patients in the CHPP group was higher than that (52.5%) of patients in the control group although the difference was not significant. Of several patterns of cancer recurrence, peritoneal recurrence was more frequent in the control group than in the CHPP group. The mortality rate from peritoneal recurrence in the case of patients in the CHPP group was much lower than that of patients in the control group (P = 0.0854). CHPP did not induce anastomotic breakdown or chemical peritonitis after surgery. Conclusions. The results indicate that CHPP is effective in preventing peritoneal recurrence of gastric cancer with serosal invasion, which is highly likely to reappear in the peritoneum.

Published
1994

35. STUDIES ON OPERATED CASES OF CHRONIC PANCREATITIS

Author

TOYOTA, Nobuhiko, primary, ASHIDA, Keigo, additional, TAKAHASHI, Sadamu, additional, KURISU, Yasuro, additional, KANEKO, Tetsuya, additional, MIZUSAWA, Kiyoaki, additional, HAMAZOE, Ryuichi, additional, and KAIBARA, Nobuaki, additional

Published
1995
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