Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients.
OBJECTIVE
To evaluate the safety, local effectiveness, and long-term results of laser thermal ablation (LTA) in the treatment of small hepatocellular carcinoma (HCC).


METHODS
Ninety-two biopsies proved small HCCs (range, 0.8-4.0 cm) in 74 patients who were treated percutaneously with LTA in an outpatient clinic. A laser at a power of 5.0 W was coupled with one to four fibers that were advanced through 21-gauge needle(s) for 6-12 minutes. All lesions were evaluated with computed tomography (CT) for changes in size and vascular pattern, recurrence rates, and cumulative survival rates. Patients were examined for complications.


RESULTS
No major complications occurred in 117 LTA sessions, with an average of 1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing area (complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6-66 months; mean, 25.3 months), 84 tumors (91%) decreased in size. The local recurrence rates (range, 1-5 years) ranged from 1.6% to 6.0%. Recurrence rates (range, 12-60 months) in other liver segments ranged from 24% to 73%. Cancer-free survival rates (range, 1-4 years) ranged from 73% to 24%. Overall survival rates were 99%, 68%, and 15% at 1, 3, and 5 years, respectively. Twenty-one patients (28%) died.


CONCLUSIONS
LTA is a safe and effective treatment for small HCC.
Pacella
C M
CM
Department of Radiology and Diagnostic Imaging, Regina Apostolorum Hospital, Via St Francesco 50, 00041 Albano Laziale, Rome, Italy. cmpacel@katamail.com
Bizzarri
G
G
Magnolfi
F
F
Cecconi
P
P
Caspani
B
B
Anelli
V
V
Bianchini
A
A
Valle
D
D
Pacella
S
S
Manenti
G
G
Rossi
Z
Z
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography