Percutaneous laser ablation of hepatocellular carcinoma in patients with liver cirrhosis awaiting liver transplantation.
OBJECTIVE
The aim of this study was to determine the effectiveness and safety of percutaneous laser ablation for the treatment of cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation.


METHODS
The data of 9 male cirrhotic patients (mean age 50 years, range 45-60 years) with 12 biopsy proven nodules of hepatocellular carcinoma (mean diameter 2.0 cm, range 1.0-3.0 cm) treated by laser ablation before liver transplantation between June 2000 and January 2006 were retrospectively reviewed. Laser ablation was carried out by inserting 300 nm optical fibers through 21-Gauge needles (from two to four) positioned under ultrasound guidance into the target lesions. A continuous wave Neodymium:Yttrium Aluminium Garnet laser was used. Transarterial chemoembolization prior to liver transplantation was performed in two incompletely ablated tumors.


RESULTS
No procedure-related major complications were recorded. During the waiting time to liver transplantation local tumor progression after ablation occurred in 3 nodules (25%). At histological examination of the explanted livers complete necrosis was found in 8 nodules (66.7%, all treated exclusively with laser ablation), partial necrosis >50% in 3 nodules (25%), and partial necrosis <50% in 1 nodule.


CONCLUSIONS
In patients with cirrhotic livers awaiting liver transplantation, percutaneous laser ablation is safe and effective for the management of small hepatocellular carcinoma.
Department of Internal Medicine, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma, Italy. mpompili@rm.unicatt.it
Maurizio
M
Pompili
Claudio Maurizio
CM
Pacella
Giampiero
G
Francica
Mario
M
Angelico
Giuseppe
G
Tisone
Paolo
P
Craboledda
Erica
E
Nicolardi
Gian Ludovico
GL
Rapaccini
Giovanni
G
Gasbarrini
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome