Multifocal carcinogenesis is caused by a persistent infection of hepatitis viruses, and is considered to be the main cause of post-operational recurrences of hepatocellular carcinoma. It has been generally believed that a single therapeutic modality (including resection therapy) cannot improve the survival rate. In this paper, we describe the efficacy of microwave coagulation therapy and its indications based on an analysis of cases experienced at our institution over a 10-year period. We compared the background factors, recurrence rate, and survival rate of various therapies, and concluded that microwave coagulation therapy is highly effective for tumor coagulation and necrosis. Microwave coagulation therapy is also technically easier than a surgical operation, has fewer complications, and results in an equally good survival rate when compared to hepatectomy. Due to these intrinsic advantages, microwave therapy is useful not only as a treatment after recurrence, but also as a primary therapy of small liver tumors. When the detection rate for small liver tumors increases, microwave coagulation therapy will start to play an even more important role in the treatment strategy for hepatocellular carcinomas as a less invasive option, in addition to laparotomic and percutaneous/laparoscopic surgeries.

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