Prognostic factors for percutaneous microwave coagulation therapy of hepatic metastases

OBJECTIVE: Microwave-induced tissue coagulation is a new approach for the local ablation of hepatic metastases. The purposes of the study were to analyze therapeutic results and those influencing factors that might be used to predict survival after percutaneous microwave coagulation therapy. SUBJECTS AND METHODS. From July 1995 to March 2002, 74 patients with 149 hepatic metastases were treated with percutaneous microwave coagulation therapy under sonographic guidance. The largest metastasis in each patient ranged from 0.7 to 6.8 cm (mean, 3.12 cm; SD, 1.81 cm). Survival rates and influencing factors were analyzed. RESULTS: The cumulative survival rates of all 74 patients were 91.4% at 1 year, 59.5% at 2 years, 46.4% at 3 years, 29% at 4 years, and 29% at 5 years. Patient age (p = 0.46) and sex (p = 0.12) and site of primary malignancies (p = 0.58) were not related to prognosis, whereas tumor grade (p = 0.01), number of metastases (p = 0.00), tumor size (p = 0.03), and local recurrence or new metastasis (p = 0.00) significantly affected survival as single independent factors. Multivariate analysis revealed that tumor grade (p = 0.03), number of metastases (p = 0.025), and local recurrence or new metastasis (p = 0.04) each had a significant effect on survival. No severe complications occurred. CONCLUSION: The probability of long-term survival for patients with one or two metastases, well-differentiated tumors, and without recurrence or new metastasis may be significantly higher than for other patients.