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survival rates of all 719 patients were 97.7%, 79.8%, 62.1%, rupture of HCC tumors. [64] With the advancement of
45.3%, and 34.1%, respectively. One-third of the patients techniques and equipment for clinical application of
had Child-Pugh Class B cirrhosis, and a portion of them microwave, MCT will be promoted more widely and used
had multiple tumors. Compared with another group of more extensively than before, through the approaches of
[20]
34 patients treated with hepatic resection during the same laparoscopy or image-guided percutaneous puncture.
period, no significant difference was found in overall survival, Regrettably, intra-hepatic recurrence of HCC is common
disease-free survival or local recurrence rates between the because MCT is indicated as a substitute for surgical resection
[53]
two groups. Based on the results of this study, the researchers for patients with advanced liver cirrhosis. Nevertheless,
proposed that MCT should be considered as one of the first MCT can be readily repeated when there is a recurrence of
[53]
options for the treatment of HCC. [55] HCC. Overall, MCT is great for cost-effectiveness compared
with other treatment for HCC like sorafenib. [65]
ADVERSE EFFECTS
The characteristic feature of MCT for the treatment of
The adverse effects of MCT for the treatment of HCC are HCC is the conversion of energy by tumor tissue from the
various and can be divided into mild, moderate, and severe microwave into heat with resultant coagulation necrosis of
categories. Mild adverse effects include slight local pain the tissue. [25,26] MCT will be more promoted because it not
[9]
at the puncture site, sensation of heat, bodily uneasiness only effectively kills HCC cells, but also preserves normal liver
felt during the coagulation process, and slightly abnormal tissue to a great extent. [59]
results from a blood test such as mild elevation of blood
urea nitrogen and creatine levels. Post-ablation syndrome Image artifacts must be recognized and carefully distinguished
[12]
can be mild to moderate and is characterized by fever, chills, from anatomical structure to ensure the accuracy of the
[66]
malaise, local pain, and nausea. Moderate adverse effects location of the needle tip. Some issue will be further
[56]
comprise bacterial infection, diaphragmatic muscle injury, investigated like the impact of MCT on the systemic immunity
[34]
skin burns, tumor implantation in needle pass, pleuritis, of the HCC patient. At present, there are very few reports
hydrothorax, hemothorax, continuous discharge of necrotic on the association of MCT used in the treatment of HCC
tissue, local implantation of tumor cells, and hematoma under and its modification of patients’ systemic immunity. Further
the hepatic capsule. [57,58] investigations into this topic are warranted.
CONCLUSION
However, severe adverse effects happen occasionally during
and after the procedures of MCT such as anesthetic accident, Microwaves can produce very high temperatures in very short
colonic leakage, severe arrhythmia, damage to the biliary time intervals. MCT is increasingly used in the treatment of
tract, abdominal bleeding, diaphragm injury, acute renal HCC because it offers several advantages such as greater
failure, generalized intra-peritoneal seeding of HCC, and efficacy, minimal invasiveness, easy conduction, wider
serious infection. [59-63] Severe adverse effects can be fatal and indications, and less adverse effects compared to other
need emergency treatment to save the patient. [63]
invasive methods. Overall, MCT for the treatment of HCC
is a very promising technique to develop further. Sufficient
The rate of side-effects do not differ significantly from other pre-operative preparation, mastering the techniques of
interventions, but significantly more treatment sessions are operation, and good collaboration between doctors,
needed with percutaneous microwave coagulation to achieve nurses, and patients are essential for enhancing therapeutic
complete tumor ablation, which theoretically increases the outcomes of HCC and reducing the incidence of side-effects.
risk of potential side-effects. Most adverse effects can Investigations should be carried out to determine the
[62]
be controlled with timely and careful management. Safety modulation by MCT of both innate and adaptive immunity.
precautions must be taken to avoid or reduce the occurrence Although MCT is still in its infancy, it has great promise for
of adverse effects including cautious indication selection, future use, especially with further improvements in the
well-designed puncture route, the appropriate extent of clinical implementation and technical developments.
coagulation, and sufficient peri-operational management. [59,61]
Financial support and sponsorship
LIMITATIONS AND PERSPECTVES Nil.

It is now proven that MCT is a safe and effective method Confl ict of interest
for the treatment of HCC and the condition of spontaneous There is no conflict of interest.

162 Hepatoma Research | Volume 1 | Issue 3 | October 15, 2015