Background: We aimed to evaluate the efficacy and long-term outcome in surgical microwave therapy (MW) for patients with unresectable hepatocellular carcinoma (HCC). Methods: An institutional review board approved and single-institutional study of surgical MW of unresectable HCC was conducted from May 2003 to December 2010. The median follow-up period was 19 months (range 1-77 months). Results: A total of 60 patients underwent 143 surgical MW for unresectable HCC. Of these, 15 patients had initial HCC and 45 had recurrent HCC. The median tumor size of HCC was 1.95 cm (range 0.8-3.3 cm). The median numbers of nodules that underwent surgical MW were 2 (range 1-9). Multinodular type was found in 33 patients (55%). Morbidity was 18.3%, and there was zero mortality. Also, 3 patients (5%) had incomplete MW. Of the 60 patients, 39 (65%) had recurrence, and 7 (11.6%) had local recurrence. The 1- and 3-year recurrence-free survival rates of the patients who underwent surgical MW for initial HCC were 55.1 and 36.7%, respectively, and those for recurrent HCC were 41.6% and 8.8%, respectively. A tumor size ≥ 2.0 cm and multiple nodules were selected as independent and significant indicators for recurrence of the disease. The 1-, 3-, and 5-year overall survival rates after the surgical MW procedure were 93.9, 53.8, and 43.1%, respectively. A level of des-gamma carboxyprothrombin (DCP) was an independent and significant indicator for overall survival. Conclusions: Surgical MW is an effective method for treating initial or recurrent unresectable HCC, and it can be undergone safely.
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